Primary Prophylaxis for Spontaneous Bacterial Peritonitis
Status:
Recruiting
Trial end date:
2023-07-01
Target enrollment:
Participant gender:
Summary
Patient with liver cirrhosis commonly have co-existing small bowel bacterial overgrowth
(SIBO) yet may be asymptomatic. It is unclear as to the value of treating SIBO in
asymptomatic individuals. Cirrhosis increase permeability of the gastrointestinal mucosa. It
is postulated that in cirrhosis, endotoxins translocate across the gut mucosal barrier
resulting in a second hit within hepatocyte perpetuating decompensation and spontaneous
bacterial peritonitis. We hypothesise that cirrhosis patients with concomitant SIBO are
particularly vulnerable for endotoxin translocation and would benefit from treatment.
Treatment of SIBO would reduce the risk of spontaneous bacterial peritonitis and other
liver-related morbidities. We aim to treat a cohort of patients with severe liver disease and
concomitant SIBO with antibiotics as prophylaxis and compare the risk of spontaneous
bacterial peritonitis, further liver-related morbidity and survival against untreated
asymptomatic controls.