Should Antibiotic Prophylaxis Be Continued for Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis? An Evidence-Based Analysis.

Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with decompensated cirrhosis. Since 1990, antibiotic prophylaxis has been widely recommended as a preventive strategy, especially with norfloxacin. However, current evidence suggests limited effectiveness in reducing mortality, an increase in resistant infections, and a high recurrence rate, which has led to questioning its net clinical benefit. This review explores the current evidence on the efficacy, risks, and alternatives to antibiotic prophylaxis in SBP.