Surgery · Shock, Fluids, Nutrition and Transfusion

A 55-year-old woman with cirrhosis and spontaneous bacterial peritonitis is started on intravenous antibiotics. According to the landmark trial by Sort et al (2007), which additional intervention reduces the risk of renal impairment in this setting?

  • A Intravenous dexamethasone 4 mg every 6 hours
  • B Intravenous albumin 1.5 g/kg on day 1 and 1 g/kg on day 3
  • C Oral norfloxacin 400 mg twice daily for 7 days
  • D Intravenous terlipressin 2 mg every 4 hours
Correct answer: B. Intravenous albumin 1.5 g/kg on day 1 and 1 g/kg on day 3

Explanation

The Sort trial demonstrated that intravenous albumin infusion (1.5 g/kg at diagnosis and 1 g/kg on day 3) combined with antibiotics significantly reduces the incidence of renal impairment and mortality in spontaneous bacterial peritonitis compared with antibiotics alone. This is standard of care in cirrhotic patients with SBP.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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