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Gulhane Med J. 2004; 46(2): 089-092

The Efficacy of Oral Ciprofloxacin Treatment in Patients with Spontaneous Ascites Infections

Dr. Hasan AYTA1, Dr. Sait BAĞCI2, Dr. Ahmet TÜZÜN2, Dr. Yüksel ATEŞ2, Dr. Zeki YEŞİLOVA2, Dr. Ahmet ERDİL2, Dr. Abdullah KILIÇ3, Dr. Necmettin KARAEREN2, Dr. Kemal DAĞALP2.

Quinolones have become promising antibiotics in the treatment of spontaneous ascites infections due to their high affinities to the enterobacteriacea family, the ability to concentrate in high levels in ascitic fluid even after taking oral single dose and their low cost. In this study, we investigated the efficacy of oral ciprofloxacin use in the treatment of spontaneous ascites infections. Fourteen patients (3 females and 11 males, mean age 48.8 ± 8.6) with various etiologies were included in the study. Ciprofloxacin tablet (500 mg bid) was given for 7 days to these patients with polimorphonuclear leukocyte (PMNL) count ³250/mm3 and/or positive culture for ascitic fluid. Polimorphonuclear leukocyte count in the ascitic fluid and culture were repeated on the 3th and 8th day of the treatment. Treatment was accepted unsuccessful in case of insufficient decrease in PMNL count to less than 50% of the basic value in ascitic fluid and continuation of culture positivity on the third day, PMNL count >250/mm3 after the 7th day of the treatment, determination of superinfection. Out of the patients, spontaneous bacterial peritonitis in 6 (43%), monobacterial non-neutrocytic bacterascites in 1 (7%) and culture negative neutrocytic ascites in 7 (50%) were defined. Treatment was accepted unsuccessful in 2 patients and a different antibiotic was started. The treatment was successful in the remaining 12 patients (86%). We didn't encounter any complication related to ciprofloxacin. Oral ciprofloxacin use for spontaneous ascites infections is quite effective in patients without serious cirrhotic complication and who will be able to adapt regularly to the treatment schedule without hospitalization.

Key words: Cirrhosis, Spontaneous ascites infection, Ciprofloxacin

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