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Daily Norfloxacin Is More Effective Than Weekly Rufloxacin in Prevention of Spontaneous Bacterial Peritonitis Recurrence

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Abstract

Our aim was to compare weekly rufloxacin with daily norfloxacin in the secondary prophylaxis of spontaneous bacterial peritonitis and to examine changes in antibiotic susceptibility in fecal Eschericia coli. The method used was an open randomized clinical trial including 79 patients who received either norfloxacin 400 mg/day or rufloxacin 400 mg/week and followed up for one year. E. coli counts, quinolone susceptibility, and drug concentrations in feces were investigated in 12 patients. Cumulative one-year probability of peritonitis recurrence was 26% for patients on norfloxacin and 36% for those on rufloxacin (P = 0.16). Norfloxacin was more effective in the prevention of peritonitis recurrence due to Enterobacteriaceae (0% vs 22%, P = .01). At the end of follow-up, all 12 patients had E. coli resistant to quinolones in their feces. In conclusion, weekly rufloxacin is not an alternative to daily norfloxacin in the prevention of peritonitis recurrence. The development of quinolone-resistant E. coli in feces may be an important problem in patients on long-term quinolone prophylaxis.

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Authors and Affiliations

  1. Liver Unit, IMD, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain

    Tilman M. Bauer, Antonio Follo, Miguel Navasa & Juan Rodés

  2. Department of Microbiology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain

    Jordi Vila

  3. Hospital Trias i Pujol, Badalona, Spain

    Ramon Planas

  4. Hospital Gregorio Marañón, Madrid, Spain

    Gerardo Clemente

  5. Hospital de la Vall d’Hebron, Barcelona, Spain

    Victor Vargas

  6. Hospital del Mar, Barcelona, Spain

    Felipe Bory

  7. Hospital Son Dureta, Palma de Mallorca, Spain

    Pere Vaquer

Authors
  1. Tilman M. Bauer
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  2. Antonio Follo
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  3. Miguel Navasa
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  4. Jordi Vila
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  5. Ramon Planas
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  6. Gerardo Clemente
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  7. Victor Vargas
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  8. Felipe Bory
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  9. Pere Vaquer
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  10. Juan Rodés
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Bauer, T.M., Follo, A., Navasa, M. et al. Daily Norfloxacin Is More Effective Than Weekly Rufloxacin in Prevention of Spontaneous Bacterial Peritonitis Recurrence. Dig Dis Sci 47, 1356–1361 (2002). https://doi.org/10.1023/A:1015386901343

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