Prophylaxis

Cirrhotic Patients with Gastrointestinal Hemorrhage

OR IF PATIENT IS NPO

*Switch to TMP/SMX once bleeding is controlled

Non-bleeding Cirrhotic Patients with Ascites

Notes

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.