Bactrim could also be simpler than ciprofloxacin in stopping cirrhosis problems
November 06, 2025
2 min learn
Key takeaways:
- Bactrim was linked to decrease danger for spontaneous bacterial peritonitis recurrence, mortality and different outcomes vs. ciprofloxacin in cirrhotic sufferers.
- Potential research are wanted to substantiate these findings.
PHOENIX — Bactrim was related to decrease danger for spontaneous bacterial peritonitis recurrence and mortality, in addition to different liver-related problems, in contrast with ciprofloxacin amongst sufferers with cirrhosis.
The information, offered at ACG Annual Scientific Assembly, present Bactrim (sulfamethoxazole/trimethoprim, Solar Pharma) may very well be a simpler choice to forestall recurrence of spontaneous bacterial peritonitis, though extra analysis is required.
Information derived from Osman MM, et al, Secondary prophylaxis of SBP in cirrhosis: Bactrim vs. ciprofloxacin in a propensity-matched real-world research. Introduced at: ACG Annual Scientific Assembly; Oct. 24-29, 2025; Phoenix (hybrid assembly).
“For those who’re culture-negative out of your spontaneous bacterial peritonitis and native resistance patterns don’t favor one or the opposite, I feel it’s honest to contemplate beginning with [Bactrim], which might usually be ciprofloxacin to start out,” Mohamad Mahdi Osman, DO, a second-year inner drugs resident at Cleveland Clinic, informed Healio.
“You do run the chance with [acute kidney injury] with [Bactrim], so that’s one thing to remember,” he added.
Spontaneous bacterial peritonitis is a life-threatening complication for sufferers with cirrhosis, and recurrence could also be prevented with sulfamethoxazole/trimethoprim or ciprofloxacin.
Actual-world comparative information on the efficacy of the 2 antibiotic regimens are missing, although.
Osman and colleagues used the TriNetX analysis community to determine grownup sufferers with cirrhosis who had been handled with sulfamethoxazole/trimethoprim or ciprofloxacin as secondary prophylaxis.
The researchers matched sufferers demographics, liver perform, MELD elements, BMI and different components to determine 11,140 pairs for evaluation.
Recurrence of spontaneous bacterial peritonitis and all-cause mortality served as main outcomes. All-cause hospitalizations, ascites, hepatic encephalopathy and variceal bleeding served as secondary outcomes.
Over a 3-year follow-up, sufferers who obtained sulfamethoxazole/trimethoprim had been 25% much less more likely to expertise peritonitis recurrence (HR = 0.75; 95% CI, 0.72-0.79) than those that obtained ciprofloxacin.
All-cause mortality (HR = 0.84; 95% CI, 0.8-0.87), ascites (HR = 0.86; 95% CI, 0.84-0.89), hepatic encephalopathy (HR = 0.79; 95% CI, 0.74-0.83) and variceal bleeding (HR = 0.81; 95% CI, 0.73-0.9) additionally had been decrease within the sulfamethoxazole/trimethoprim group.
The researchers famous decreases in all-cause hospitalizations within the sulfamethoxazole/trimethoprim group, however the distinction was not statistically important.
“I assumed we’d possibly see no variations or possibly one would present a slight suggestion that it’s a bit of bit higher,” Osman stated. “However the truth that it was so widespread was a bit of bit shocking.”
Notably, sufferers who obtained ciprofloxacin had been much less more likely to expertise acute kidney damage (27.3% vs. 29%), a statistically important discovering.
Osman acknowledged research limitations, together with its retrospective design and attainable confounding variables. Future potential research might present extra concrete information evaluating the 2 regimens.
“It’s not honest to conclude that [Bactrim] is best simply primarily based on this one research,” he stated.
For extra data:
Mohamad Mahdi Osman, DO, might be reached at newsroom@ccf.org.
Sources/Disclosures
Supply:
Osman MM, et al, Secondary prophylaxis of SBP in cirrhosis: Bactrim vs. ciprofloxacin in a propensity-matched real-world research. Introduced at: ACG Annual Scientific Assembly; Oct. 24-29, 2025; Phoenix (hybrid assembly).
Disclosures:
Osman studies no related monetary disclosures. Please see the research for all different authors’ related monetary disclosures.
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