{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:31:54Z","timestamp":1785472314460,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cirrhosis is a major global health concern due to its progressive nature and high risk of complications, including spontaneous bacterial peritonitis (SBP), which significantly increases mortality. Quinolone antibiotics, especially norfloxacin, are commonly used for SBP prophylaxis in high\u2010risk cirrhotic patients, but the long\u2010term impact on overall mortality remains uncertain. The purpose of this meta\u2010analysis and systematic review is to evaluate how quinolone prophylaxis affects the SBP incidence, mortality, and non\u2010SBP infections in cirrhosis patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search of Web of Science, Embase, and PubMed identified research evaluating quinolone prophylaxis on the risk of spontaneous bacterial peritonitis (SBP) and mortality in cirrhotic patients. Inclusion criteria included randomized controlled trials reporting risk ratios for patients on quinolone prophylaxis versus controls. A random\u2010effects meta\u2010analysis pooled the results, with heterogeneity assessed by the I<jats:sup>2<\/jats:sup> statistic. Sensitivity analyses were performed for robustness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search screened 1754 items and identified 6 relevant studies. Quinolone prophylaxis was associated with a significantly lower risk of spontaneous bacterial peritonitis (SBP), non\u2010SBP infections, and mortality in cirrhotic patients, with a pooled relative risk (RR) for SBP of 0.47 (95% CI: 0.22\u20131.01), for non\u2010SBP infections of 0.79 (95% CI: 0.66\u20130.94), and for mortality of 0.67 (95% CI: 0.52\u20130.86). Sensitivity analysis confirmed the robustness of these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis reveals that quinolone prophylaxis significantly lowers the risk of spontaneous bacterial peritonitis (SBP), other infections, and mortality in high\u2010risk cirrhotic patients. The results support incorporating quinolone prophylaxis in cirrhosis management to improve outcomes, with future studies needed to refine treatment duration and patient\u2010specific strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.70148","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T11:44:01Z","timestamp":1744890241000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Quinolone Prophylaxis on Spontaneous Bacterial Peritonitis and Mortality in Cirrhosis Patients: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"9","author":[{"given":"Ajay","family":"Malvi","sequence":"first","affiliation":[{"name":"National Institute of Pharmaceutical Education and Research  Guwahati India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4328-0914","authenticated-orcid":false,"given":"Nipun","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Hepatology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahalaqua Nazli","family":"Khatib","sequence":"additional","affiliation":[{"name":"Division of Evidence Synthesis, Global Consortium of Public Health and Research Datta Meghe Institute of Higher Education  Wardha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subbulakshmi","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biochemistry, School of Sciences JAIN (Deemed to Be University)  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Allied Healthcare and Sciences Vivekananda Global University  Jaipur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Endocrinology NIMS University  Jaipur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Barwal","sequence":"additional","affiliation":[{"name":"Chandigarh Pharmacy College Chandigarh Group of College  Mohali Punjab India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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