Continuous using of antimicrobial agents less than 6 months or using non-fluoroquinolone antimicrobial agents reduced the occurrence of spontaneous bacterial peritonitis and improved the survival rates in cirrhosis: A meta-analysis

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Objective: To systematically investigate the effects of the continuous use time and the types of antibacterial drugs in reducing the incidence of spontaneous bacterial peritonitis (SBP) and the mortality rates in liver cirrhosis patients. Material and Methods: Random controlled trials (RCTs) researches using antibacterial drugs in prevention of SBP in English, Chinese and Korean were retrieved in PubMed, Cochrane, Embase and CNKI (Chinese National Knowledge Infrastructure) by computer, and the retrieval time was from January 1990 to April 2014. The literature was screened according to inclusion and exclusion criteria, extracted data and evaluated the qualities by two independent researchers. In the end, a meta-analysis was conducted using RevMan5.2 software. Results: A total of 15 documents included in the case study were 1470 cases, 847 cases in control group and 623 cases in the treatment group. Compared with placebo, using of antibacterial drugs less than 6 months in patients with cirrhosis could reduce the mortality rate by 17%, and reduce the incidence of SBP by 30%, which both exceeded the corresponding data of using antibacterial drugs more than 6 months (10%, 14%); non-fluoroquinolone antibacterial drugs used in patients with cirrhosis could reduce the mortality rate by 20%, and reduce the incidence of SBP by 33%, they both exceeded the corresponding data of using ciprofloxacin (10%, 12%) or norfloxacin (6%, 20%). Conclusions: Continuous using of antimicrobial agents less than 6 months and using antimicrobial agents beyond fluoroquinolone can significantly reduce the mortality rate and the incidence of SBP in patients with cirrhosis.