A NATIONAL SURVEY SHOWS A DILEMMA TOWARDS SBP PROPHYLAXIS AMONG US-BASED HEPATOLOGY PROFESSIONALS
Clin Transl Gastroenterol. 2025 May 13. doi: 10.14309/ctg.0000000000000858. Online ahead of print.
ABSTRACT
BACKGROUND: Spontaneous bacterial peritonitis prophylaxis (SBPPr)-related practices are evolving, with recent studies showing almost half of potential subjects not being initiated on it.
AIM: Determine practice dilemmas regarding SBPPr among US-based hepatology providers.
METHOD: A questionnaire regarding primary and secondary SBPPr using quantitative and qualitative (open-ended) approaches was sent to US-based hepatology providers electronically.
RESULTS: 113 clinicians (86% physicians, 73% academic centers) responded. 54% started Primary and 72% secondary SBPPr in 50% of eligible patients. However, the issues related to antimicrobial resistance (AMR) and ineffectiveness lead to SBPPr usage variations and restrictions on a patient-specific basis. Most respondents (>70%) would withdraw/not initiate SBPPr with data regarding ineffectiveness and harms. Open-ended answers showed that most believed newer trials to reduce reliance on weaker older evidence are needed.
CONCLUSION: A survey of US-based hepatologists demonstrates a major dilemma between usual care of initiating SBPPr versus not initiating/withdrawing SBPPr that needs newer randomized trials.
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