Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2015; 7(3): 304-314
Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.304
Spontaneous bacterial peritonitis: The clinical challenge of a leaky gut and a cirrhotic liver
Philipp Lutz, Hans Dieter Nischalke, Christian P Strassburg, Ulrich Spengler
Philipp Lutz, Hans Dieter Nischalke, Christian P Strassburg, Ulrich Spengler, Department of Internal Medicine I, University of Bonn, D-53129 Bonn, Germany
Philipp Lutz, Christian P Strassburg, Ulrich Spengler, German Center for Infection Research, 38124 Braunschweig, Germany
Author contributions: Lutz P wrote the article; Nischalke HD, Strassburg CP and Spengler U critically revised the article.
Conflict-of-interest: No conflicts interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Philipp Lutz, Department of Internal Medicine I, University of Bonn, Sigmund-Freud-Strasse 25, D-53129 Bonn, Germany.
Telephone: +49-228-28715507 Fax: +49-228-28751419
Received: August 28, 2014
Peer-review started: August 29, 2014
First decision: November 14, 2014
Revised: November 30, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: March 27, 2015
Core Tip

Core tip: Spontaneous bacterial peritonitis (SBP) is a frequent infection in patients with liver cirrhosis which is associated with a poor prognosis. Portal hypertension leads to translocation of intestinal bacteria which cannot be eliminated due to immune defects caused by liver cirrhosis and genetic predisposition. Empirical antibiotic treatment has become less effective because of wide-spread antibiotic resistance. This review summarises key features of SBP and points out how diagnosis, treatment and prophylaxis may be improved in the future in order to reduce mortality.