Introduction β Blockers may have a protective effect on the development of spontaneous bacterial peritonitis by increasing the intestinal transit time and reducing portal pressure. The aim of this study is to evaluate the significant benefit of β blocker in prevention of spontaneous bacterial peritonitis in patients with chronic liver disease and ascites.
Methods We retrospectively evaluated 332 patients with cirrhosis and ascites admitted over a period of 5 years (males 230, females 102). Diagnosis of spontaneous bacterial peritonitis was based on an ascitic fluid neutrophilic count of >250/mm3 and/or a positive culture without evidence of secondary peritonitis.
Results Spontaneous bacterial peritonitis was diagnosed in 52 of 332 (15.66%) patients. Of the 92 on β-blockers, 6 (6.5%) had SBP and out of 240 patients who were not on β-blockers, 46 (19.2%) had SBP. The patients who were on β-blockers, had a significantly lower incidence of SBP (χ2 test with continuity correction; p=0.008).
Conclusion Our data indicate that spontaneous bacterial peritonitis significantly increases mortality in patients with cirrhosis. Propranolol therapy was found to be associated with a significantly lower risk for spontaneous bacterial peritonitis, but a Type II statistical error cannot be definitely excluded. The potential protective effect of propranolol on the incidence of spontaneous bacterial peritonitis might deserve evaluation in properly designed prospective studies.
Competing interests None declared.
Reference 1. Senzolo M, Cholongitas E, Burra P, et al. β-Blockers protect against spontaneous bacterial peritonitis in cirrhotic patients: a meta-analysis. Liver Int 2009;29:1189–93.
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