{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:05:07Z","timestamp":1792263907000,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T00:00:00Z","timestamp":1556150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Several antibiotic treatments aiming to prevent spontaneous bacterial peritonitis (SBP) in cirrhotic patients with low\u2010protein content in ascitic fluid have been tested; however, there are limited data on the comparative efficacy of these regimens. We assessed their comparative efficacy through a network meta\u2010analysis and using GRADE criteria to appraise quality of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Through literature review through October 2018, we identified 10 randomized controlled trials comparing antibiotic treatments (norfloxacin, ciprofloxacin, trimethoprim\/sulfamethoxazole and rifaximin) with each other or placebo. Primary outcome was SBP occurrence, with mortality rate and rate of other infections as secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In comparison with placebo, moderate quality evidence supports the use of norfloxacin and ciprofloxacin in primary prophylaxis of SBP (risk ratio 0.23; 95% CI, 0.09\u20100.56; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001 and 0.23; 0.07\u20100.79; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02 respectively) while only low quality evidence suggests superiority of rifaximin (risk ratio 0.15; 0.05\u20100.42). When antimicrobial agents were compared to each other, no significant difference was found. With regard to mortality, moderate quality supports the superiority of norfloxacin over placebo (risk ratio, 0.68; 95% CI, 0.47\u20100.99; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04), while ciprofloxacin and rifaximin showed only a non\u2010significant benefit and no significant difference was found in the other comparisons. None of the tested antibiotics proved to significantly decrease the rate of other infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Norfloxacin appears to have significant benefit both in terms of SBP prevention and mortality; ciprofloxacin represents a valuable option although without a clear survival benefit. Rifaximin shows interesting results but needs to be tested in further trials.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14109","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T15:17:32Z","timestamp":1553786252000},"page":"1448-1458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Comparative efficacy of long\u2010term antibiotic treatments in the primary prophylaxis of spontaneous bacterial peritonitis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2107-2156","authenticated-orcid":false,"given":"Antonio","family":"Facciorusso","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Papagiouvanni","sequence":"additional","affiliation":[{"name":"Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Cela","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo R.","family":"Buccino","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Sacco","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Sciences University of Foggia Foggia 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