%0 Journal Article
%T Role of Pentoxifylline and Sparfloxacin in Prophylaxis of Spontaneous Bacterial Peritonitis in Cirrhotic Patients
%A Tarek Mohammed Mostafa
%A Osama Mohamed Ibrahim
%A Gamal Abd El-Khalek Badra
%A Mahmoud Samy Abdallah
%J ISRN Gastroenterology
%D 2014
%R 10.1155/2014/595213
%X This study was directed to evaluate the role of sparfloxacin and pentoxifylline in the prophylaxis of spontaneous bacterial peritonitis in cirrhotic patients. Forty cirrhotic patients with ascites were included in the study. Patients were randomized into four groups in a blind fashion; each group consists of ten patients. Group one received ciprofloxacin (control group), group two received sparfloxacin, group three received pentoxifylline, and group four received a combination of sparfloxacin and pentoxifylline. Treatment duration was six months. Serum TNF-¦Á level was the primary inflammatory marker of the study to evaluate the effect of the used medications. In group two, TNF-¦Á level showed a statistically significant decrease in comparison with group one ( ), while in group three, TNF-¦Á level showed nonsignificant difference in comparison with the control group ( ). In addition, group four showed a statistically significant decrease in TNF-¦Á level compared to the other three groups ( ). The finding from our study indicates that sparfloxacin as well as pentoxifylline could be used in prophylaxis of spontaneous bacterial peritonitis. Combination of sparfloxacin and pentoxifylline showed some of synergism which may be useful in decreasing emergence of resistant strains. 1. Introduction Spontaneous bacterial peritonitis (SBP) is a common and severe complication of cirrhotic patients having ascites with a prevalence rate between 10 and 30% characterized by spontaneous infection of ascitic fluid which occurs in the absence of any infection or perforation of intra-abdominal organs [1]. Approximately 20% of patients are already infected at the time of admission and nearly 50% develop an infection during hospitalization [2]. Patients with the greatest risk for the development of SBP are those who have recovered from the first episode. In these patients, the recurrence rate is very high; the probability of developing a new episode of SBP ranges from 40% to 70% within the first-year followup [3, 4]. SBP is now associated with in-hospital mortality rates ranging from 20% to 40% [5]. Furthermore, mortality rates one and two years after an episode of SBP are reported to be 50¨C70% and 70¨C75%, respectively [6]. However, mortality after SBP is improved owing to early diagnosis and prompt treatment with empiric antibiotics. Bacterial translocation (BT) and migration of viable microorganisms from the intestinal lumen to the mesenteric lymph nodes and other extraintestinal sites have been postulated as the main mechanism in the pathogenesis of SBP [7¨C9]. Translocation of
%U http://www.hindawi.com/journals/isrn.gastroenterology/2014/595213/