Background and study aim: Spontaneous bacterial peritonitis (SBP) is a frequent complication in ‎cirrhotic patients with ascites with significant morbidity and mortality. In ‎patients with liver disease, there are many indications for acid ‎suppressive therapy. Proton pump inhibitors (PPIs) are the most ‎frequently prescribed drugs for acid suppression in patients with ‎cirrhosis. Several studies evaluating the risk of SBP in patients on PPIs ‎use have shown conflicting results. This study aimed at exploring ‎whether PPIs use in Egyptian cirrhotic patients with ascites is associated ‎with spontaneous bacterial peritonitis development‎‎‎.
Patients and Methods: ‎The study included 209 patients with liver cirrhosis and ascites. ‎According to ascitic fluid polymorphonuclear leucocyte (PMN) cell ‎count, patients were allocated into: SBP group (PMN > 250 cell/ mm³), ‎and non-SBP group (PMN < 250 cell/ mm³). Both groups were ‎compared to each other as regards rate of PPIs use, PPIs types and their ‎indication‎‎.‎
Results: Out of 209 cirrhotic patients with ascites, SBP was detected in 34.9% of ‎patients whether they were on PPIs or not. SBP patients had a ‎significant higher use of PPIs therapy (72.6%) than the non-SBP ‎patients (26.5%) (P<0.001). However, there was no statistical significant ‎difference regarding type of PPIs or indications of use (P>0.05)‎‎‎‎‎‎‎‎‎.
Conclusion: The rate of PPIs use was higher in SBP patients than in patients without ‎SBP. There were no differences regarding PPIs types or indications of ‎use between both groups. Thus, PPIs therapy should be judiciously used ‎and only when indicated in patients with liver cirrhosis and ascites‎.