Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2005; 11(43): 6823-6827
Published online Nov 21, 2005. doi: 10.3748/wjg.v11.i43.6823
Single daily amikacin versus cefotaxime in the short-course treatment of spontaneous bacterial peritonitis in cirrhotics
Tai-An Chen, Gin-Ho Lo, Kwok-Hung Lai, Whey-Jen Lin
Tai-An Chen, Gin-Ho Lo, Kwok-Hung Lai, Whey-Jen Lin, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Gin-Ho Lo, Division of Gastroenterology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan, China.
Telephone: +886-7-3468078 Fax: +886-7-3468237
Received: January 18, 2005
Revised: June 28, 2005
Accepted: July 1, 2005
Published online: November 21, 2005

AIM: To compare the efficacy and safety of single daily amikacin vs. cefotaxime in the 5-d treatment of spontaneous bacterial peritonitis (SBP).

METHODS: Thirty-seven cirrhotic patients with SBP, 19 in group A and 18 in group B, were studied. Group A received 1 g of cefotaxime every 6 h, and group B received 500 mg of amikacin qd. Both antibiotics were administered up to 5 d and the responses were compared.

RESULTS: Infection was cured in 15 of 19 patients (78.9%) treated with cefotaxime and in 11 of 18 (61.1%) treated with amikacin. Four patients of the Cefotaxime group (21.1%) and five patients of the Amikacin group (27.8%) died. Two in each group (10.5% vs 11.1%) had renal impairment during study period. One in each group (5.3% vs 5.6%) may be considered to suffer from nephrotoxicity due to increased urinary β2-microglobulin concentration.

CONCLUSION: In this study, single daily doses of amikacin in the treatment of SBP in cirrhotics were not associated with an increased incidence of renal impairment or nephrotoxicity. However, a 5-d regimen of amikacin is less effective than a 5-d regimen of cefotaxime in the SBP treatment.

Keywords: Spontaneous bacterial peritonitis, Amikacin, Cefotaxime