TMP/SMX 1 DS PO daily
OR IF PATIENT IS NPO
Ceftriaxone 1 g IV every 24 hr*
*Switch to TMP/SMX once bleeding is controlled
All patients with cirrhosis and upper GI bleeding should receive prophylaxis for 7 days (50% develop SBP after bleed).
Patients who get SBP should get lifelong prophylaxis to prevent future episodes (40-70% risk of recurrence in 1 year).
Prophylaxis should be considered for those with low protein concentrations in ascites (<10 g/L) or immunosuppression but must be carefully weighed against the risk of resistance.