Comparison of cefotaxime and ofloxacin in treatment of spontaneous bacterial peritonitis

Gold-standard treatment of spontaneous bacterial peritonitis currently involves 3rd generation cephalosporins. To evaluate the efficacy of ofloxacin in this infection, we compared a combined therapy with intravenous and oral ofloxacin to intravenous cefotaxime. Thirty cirrhotic patients with spontaneous bacterial peritonitis were assigned to receive either intravenous (1 g/12 h) cefotaxime for 7 days (n=17) or intravenous (200 mg/12 h) ofloxacin for 2 days followed by oral (200 mg/12 h) ofloxacin for 5 days (n=13). All cases had community-acquired spontaneous bacterial peritonitis. The infection resolution rate on the 7th day of therapy was 82.4% in the cefotaxime group and 92.3% in the ofloxacin group. Hospital survival rates were 82.4% and 100%, respectively. Oral ofloxacin after a short course of intravenous ofloxacin is effective in the treatment of uncomplicated spontaneous bacterial peritonitis. This regimen may allow physicians to treat these patients as outpatients as soon as their intravenous therapy is completed.