6/28/23, 12:51 AM Albumin for SBP Pathway Feedback Search Clinical Topics Home Studies Albumin for SBP Albumin for SBP Disease Disease Liver cirrhosis Spontaneous bacterial peritonitis Trial question Is antibiotics plus intravenous albumin superior to antibiotics alone in patients with cirrhosis and SBP? Study design Multi-center Double blinded RCT Population Characteristics of study participants 36.0% female N = 126 64.0% male 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) https://web.pathway.md/studies/reckcFqlg4kzuUgLR 1/2 6/28/23, 12:51 AM Albumin for SBP Pathway Primary outcome Renal impairment 33.0 % 33 24.8 % 16.5 % Significant decrease 10 8.3 % NNT = 4 0.0 % Cefotaxime and albumin Cefotaxime alone 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. Reference Sort P, Navasa M, Arroyo V et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999 Aug 5;341(6):403- 9. Open reference URL https://web.pathway.md/studies/reckcFqlg4kzuUgLR 2/2