Albumin for SBP

Albumin for SBP

Is antibiotics plus intravenous albumin superior to antibiotics alone in patients with cirrhosis and SBP?

Study design

Population

• 126 patients (45 female, 81 male)
• Inclusion criteria: patients with cirrhosis and SBP
• Key exclusion criteria: treatment with antibiotics, gastrointestinal bleeding, organic nephropathy, a serum creatinine level > 3 mg/dL, cardiac failure, age > 80 years, septic shock, or dehydration

Interventions

• N=63 cefotaxime and albumin (cefotaxime daily, dosage varied according to the serum creatinine level, and albumin given at a dose of 1.5 g/kg of body weight at the time of diagnosis, followed by 1 g/kg on day 3)
• N=63 cefotaxime alone (daily dosage varied according to the serum creatinine level)

Primary outcome

Significant decrease in renal impairment (10% vs. 33%;

RR 0.3, 95% CI 0.11 to 0.49)

Secondary outcomes

Significant decrease in in-hospital death (10% vs. 29%;

RR 0.34, 95% CI 0.08 to 0.6)

Safety outcomes

No significant difference in rate of adverse events.

Conclusion

In patients with cirrhosis and SBP, cefotaxime and albumin were superior to cefotaxime alone with respect to renal impairment.