a) In patients with hepatic cirrhosis and ascites, list three risk factors for developing spontaneous bacterial peritonitis. (30% marks)
b) In a patient with suspected spontaneous bacterial peritonitis, explain your approach to antimicrobial therapy. (40% marks)
c) List three further management priorities for the management of spontaneous bacterial peritonitis. (30% marks)
Risk factors for SBP could include:
b) "Explain your approach to antimicrobial therapy" in a patient with "suspected" SBP, they asked. Well, first:
c) "Three further management priorities"
These recommendations cannot be found together in any specific guideline, and represent a melange of several publications, not the least of which is the UpToDate article by Runyon and the EASL clinical practice guidelines from 2010.
Such, Jose, and Bruce A. Runyon. "Spontaneous bacterial peritonitis." Clinical infectious diseases (1998): 669-674.
Foris, Lisa A., and Melanie T. Stapleton. "Spontaneous Bacterial Peritonitis." (2017).
Koulaouzidis, Anastasios, Shivaram Bhat, and Athar A. Saeed. "Spontaneous bacterial peritonitis." World Journal of Gastroenterology: WJG 15.9 (2009): 1042.
Runyon, Bruce A. "Chapter 91. Ascites and Spontaneous Bacterial Peritonitis." (2002). Ch. 91; in:
European Association For The Study Of The Liver. "EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis." Journal of hepatology 53.3 (2010): 397-417.