A Study on Diagnosis and Treatment of End Stage Liver Disease Complicated With Infection (SESLDIP Study)

NCT ID: NCT03362632

Last Updated: 2018-09-13

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 400 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-07-01
• Study Completion Date: 2019-06-30

Brief Summary

Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease due to various causes. The initial anti-infective medication is appropriate and the patient's survival rate is closely related. Ascitic fluid bacterial culture takes a long time, the positive rate is low, it is difficult to guide the timely use of antimicrobial drugs, empirical medicine based on evidence-based medicine for SBP in patients with end-stage liver disease is essential. The American College of Hepatology and the European Society of Hepatology recommend the use of third-generation cephalosporins as the first choice of empirical therapy in patients with end-stage liver disease associated with community-acquired SBP. Patients with merger of hospital-acquired SBP with piperacillin / tazobactam or carbapenem +/- glycopeptide antibiotics is the first choice for empirical medication. There is no clear recommendation in China. In recent years, the conclusions of international clinical research in this area have been in disagreement with the recommendations. As a key factor in the selection of empirical antibiotics is local bacterial resistance data, these findings are difficult to evidence-based medicine for Chinese doctors. This project intends to observe the efficacy of different initial anti-infective regimens in Chinese patients with end-stage liver disease with SBP and 30-day and 60-day non-liver transplant survival rates, providing evidence-based medical evidence for the empirical use of such patients.

Conditions

End Stage Liver Disease; Infection; Spontaneous Bacterial Peritonitis

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

Infection Group

Patients with end stage liver disease with SBP

Antibiotics

Intervention Type: DRUG

This is an observation study, no specific antibiotics will be indicated during treatment.

Non-infection Group

Patients with end stage liver disease without SBP

No interventions assigned to this group

Interventions

Antibiotics

This is an observation study, no specific antibiotics will be indicated during treatment.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. Meet the end-stage liver disease part of the type of standard (including slow plus acute liver failure, chronic liver failure, cirrhosis decompensation);

2. age> 18 years old

3. ascites nucleated cell count> 250 × 106 / L;

4. Unable to obtain ascites specimens or ascites nucleated cells count does not meet the conditions of 3) are required abdominal examination tenderness (+), rebound tenderness (+), abdominal ultrasound can detect ascites, and procalcitonin (PCT) > 0.5ng / ml, hs-CRP> 10ng / ml

Exclusion Criteria

1. history of abdominal surgery within 4 weeks;

2. secondary peritonitis;

3. tuberculous peritonitis;

4. Malignant tumor;

5. patients who use hormones or immunosuppressants;

6. AIDS patients;

7. heart failure or respiratory failure;

8. merge other parts of the infection;

9. died within 48h;

10. liver transplantation during observation;

11. Diagnosis of spontaneous bacterial peritonitis is the use of carbapenems or third-generation cephalosporins / enzyme inhibitors, piperacillin / enzyme inhibitor antibiotics

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Tongji Hospital

OTHER

Sponsor Role: lead

Responsible Party

Qin Ning

Director of Department of Infectious Disease

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, China

Countries

China

Other Identifiers

SESLDIP study

Identifier Type: -

Identifier Source: org_study_id