Comparative outcomes of Piperacillin-Tazobactam versus Ceftriaxone in managing spontaneous bacterial peritonitis in cirrhotic patients: An observational study

Azhar Hussain; Muhammad Umer Sheikh; Ambreen Tauseef; Hafiz Ghulam Mohayudin; Hira Sadaqat; Waqar Ahmed Siddiqui

doi:10.53685/jshmdc.v6i1.358

Authors

Azhar Hussain Department of Gastroenterology, Services Institute of Medical Sciences, Lahore, Pakistan
Muhammad Umer Sheikh Department of Gastroenterology, Services Institute of Medical Sciences, Lahore, Pakistan
Ambreen Tauseef Department of Pharmacology, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan3
Hafiz Ghulam Mohayudin Department of Gastroenterology, Services Institute of Medical Sciences, Lahore, Pakistan
Hira Sadaqat Department of Gastroenterology, Services Institute of Medical Sciences, Lahore, Pakistan
Waqar Ahmed Siddiqui Department of Pharmacology, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan

DOI:

https://doi.org/10.53685/jshmdc.v6i1.358

Keywords:

Spontaneous Bacterial Peritonitis,, Piperacillin-Tazobactam,, Ceftriaxone, Cirrhosis

Abstract

Background: Spontaneous bacterial peritonitis (SBP), a serious complication of liver cirrhosis, demands prompt antibiotic treatment, but rising resistance to ceftriaxone has spurred interest in alternative therapies.

Objective: To compare the treatment outcomes of Piperacillin-Tazobactam versus ceftriaxone in spontaneous bacterial peritonitis among cirrhotic patients.

Methods: This comparative observational study was conducted from 1^st January to 1^st July 2023 at the Services Institute of Medical Sciences, Lahore, Pakistan. A total of 218 cirrhotic patients, 18-60 years of age, diagnosed with SBP based on an ascitic fluid polymorphonuclear (PMN) count >250/μL, were enrolled using non-probability consecutive sampling. On the physician’s discretion, patients receiving Piperacillin-Tazobactam (4.5 g IV every 8 hours) were allocated to Group A (n=109) and those receiving Ceftriaxone (2 g/day) were allocated to Group B (n=109). Treatment response was observed on day five by assessing clinical improvement and repeat ascitic fluid analysis. A Chi-square test was conducted using SPSS version 22 for statistical analysis.

Results: The mean age of the study population was 35.7 ± 6.5 years, with 61.93% male patients. A higher proportion of patients treated with Piperacillin-Tazobactam (75.2%) showed resolution of SBP by day 5 compared to those receiving Ceftriaxone (62.4%). Although there was a difference in the response to the treatments (χ²=3.61, p=0.0574), it was statistically not significant. Across stratified subgroups, age, gender, symptom duration, Child-Pugh score, and PMN count for the Piperacillin-Tazobactam (group A) showed higher, though statistically insignificant, treatment response rates compared to Ceftriaxone (group B).

Conclusion: Piperacillin-Tazobactam showed a higher, though statistically insignificant, resolution rate of SBP compared to Ceftriaxone. This trend was consistent across age groups, gender, symptom duration, Chil-Pugh score, and PMN count, suggesting a potential clinical advantage.

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