Relationship between proton pump inhibitor therapy and spontaneous bacterial peritonitis in cirrhotic patients with ascites

Abstract

Objective: To demonstrate the relationship between proton pump inhibitor (PPI) and spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites. Material and Method: A total of 157 cirrhotic patients with ascites who underwent diagnostic paracentesis from January 2006 to October 2011 were included. SBP was defined as more than 250/mm polymorphonuclear leukocytes with or without a positive culture from the ascitec fluid. Result: 38 patients had SBP and 119 did not. On multivariate analysis, hepatocellular carcinoma (OR = 5.09, 95% CI 2.09―13.05; p＜0.01), MELD score (＞=20, OR = 3.57, 95% CI 1.40―9.69, p＜ 0.01), PPI use (OR = 2.60, 95% CI 1.13―6.12; p = 0.02) were risk factor for SBP. Conclusion: PPI use, as well as with hepatocellular carcinoma and high MELD score, was an independent risk factor for the development of SBP in cirrhotic patients with ascites We recommend that we should use carefully PPI to cirrhotic patients with ascites Further prospective studies are warranted to clarify this issue.