{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:02:25Z","timestamp":1789437745963,"version":"build-2803163510"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhosis requiring immediate empirical antibiotic therapy. Third-generation cephalosporins are the traditional agents of choice; however, increasing clinical failure rates necessitate the evaluation of alternative antibiotics to ensure optimal therapeutic outcomes. The aim was to investigate the efficacy of cefoxitin versus cefotaxime for SBP treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized clinical trial was conducted on 140 cirrhotic patients with community-acquired SBP at Al-Rajhy Liver University Hospital, Assiut, Egypt. Patients were randomized to receive either cefotaxime (n\u200a=\u200a70) or cefoxitin (n\u200a=\u200a70), 2\u2005g every 8\u2005h for 5\u2005days. Polymorphonuclear neutrophil (PMN) counts were measured upon admission, on Day 2 and on Day 5. Clinical response rates at Days 2 and 5, development of hepatorenal syndrome, length of stay and mortality were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>According to intention-to-treat analysis, clinical response rates at Day 2 were 74.2% in the cefotaxime group and 80% in the cefoxitin group, while at Day 5, they were 71.4% and 74.3%, respectively (P\u200a=\u200a0.704). The PMN counts at Days 0, 2 and 5 showed no significant differences between the cefotaxime and cefoxitin groups (P\u200a=\u200a0.889, 0.909 and 0.360, respectively). The incidence of hepatorenal syndrome was 7.1% in the cefotaxime group compared with 8.6% in the cefoxitin group (P\u200a=\u200a0.753), and mortality was 15.7% and 12.9%, respectively (P\u200a=\u200a0.629).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cefoxitin showed comparable effectiveness to cefotaxime but may be utilized in selected clinically stable SBP patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag318","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:14:56Z","timestamp":1788520496000},"source":"Crossref","is-referenced-by-count":0,"title":["Cefoxitin versus cefotaxime as empirical treatment of spontaneous bacterial peritonitis in liver cirrhotic patients: randomized controlled clinical trial"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6244-7488","authenticated-orcid":false,"given":"M A M","family":"Ebrahim","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Unit, Al-Rajhy Liver University Hospital, Assiut University , Assiut ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A M","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University , Assiut ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M M M","family":"Abdel-Latif","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University , Assiut 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