P-163. Trimethoprim-Sulfamethoxazole is Associated with Decreased Mortality Compared to Fluoroquinolones for Secondary Prophylaxis of Spontaneous Bacterial Peritonitis: A Global Network Analysis
Abstract
Abstract Background Historically, fluroquinolones and trimethoprim-sulfamethoxazole (TMP-SMX) have been used for secondary prophylaxis for spontaneous bacterial peritonitis (SBP). Previous studies with smaller populations have shown that there is no difference in mortality and efficacy between the two. We aimed to look at mortality rates and other adverse events related to taking fluoroquinolones versus TMP-SMX for SBP prophylaxis in a global retrospective cohort study. Methods Patients were selected in the TrinetX database from January 1, 2015 to April 1, 2025. Inclusion criteria included age over 18 and index diagnosis of SBP. Patients with death or liver transplant within one month were excluded. Those with prescription of either ciprofloxacin or norfloxacin within four months were then added and excluded from the TMP/SMX group, and vice versa. Patients without any documented labs between 18 and 24 months after diagnosis were excluded. The two groups were then propensity matched for values listed in Table 1. Odds ratio and Kaplan-Meier survival analysis was then conducted on rates of death, recurrent SBP, C. difficile, bacteremia, pneumonia, and liver transplant within two years following index diagnosis.Figure 1. Kaplan-Meier survival curve comparing mortality in patients who received TMP-SMX versus those who took fluoroquinolones for SBP prophylaxis. Results Prior to propensity matching, baseline demographics were similar (Table 1). After matching, we had 626 patients…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 626 participants or records.
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