Medication list review  Is patient receiving medications as ordered  Deep vein thrombosis prophylaxis--subcutaneous heparin or pneumatic boots if contraindicated (elevated INR unrelated to Coumadin is not a contraindication)  Beta-blocker for known varices or documented contraindications to beta- blockers Spontaneous bacterial peritonitis
(SBP)  Prophylaxis with either Cipro 500 mg once a day or Bactrim DS once a day for one of the following: 1.
Norfloxacin and cisapride combination decreases the incidence of spontaneous bacterial peritonitis
in cirrhotic ascites.
High levels of tumor necrosis factor-[alpha] and interleukin-6 in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis
Current management of the complications of cirrhosis and portal hypertension: Variceal hemorrhage, ascites, and spontaneous bacterial peritonitis
2) Serious complications from cirrhosis, which may contribute to hospitalization and even death, include variceal bleeding, spontaneous bacterial peritonitis
, hepatocellular carcinoma, hepatorenal syndrome, hepatic encephalopathy, and hepatopulmonary syndrome.
Pretransplant antimicrobial drug exposure also includes norfloxacin prophylaxis in patients with a history of spontaneous bacterial peritonitis
Enteric microorganisms are the common cause of spontaneous bacterial peritonitis
The most common bacterial infections in these patients are spontaneous bacterial peritonitis
, urinary tract infection, and bacteremia.
Reports are also available for atypical presentations, including pneumonia after aspiration of seawater, septic arthritis, epiglottitis, spontaneous bacterial peritonitis
, meningitis, endometritis, myositis, osteomyelitis, and corneal ulcer.
Spontaneous bacterial peritonitis
due to Yersinia enterocolitica in secondary alcoholic hemochromatosis.
A diagnosis of spontaneous bacterial peritonitis
associated with alcoholic liver cirrhosis was made, and the patient was treated with 2 g/day of ceftriaxone.
Patients with cirrhosis are prone to small bowel bacterial overgrowth, which has been shown to correlate with increased rates of infection, particularly spontaneous bacterial peritonitis