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SBP Treatment in Palliative Cirrhosis — SCE Palliative Medicine MCQ

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HardGI SymptomsSBP Treatment in Palliative CirrhosisSCE Palliative Medicine

A patient with cirrhosis and palliative goals develops probable spontaneous bacterial peritonitis. Previous episodes responded to treatment and he wants potentially reversible problems treated. What is appropriate?

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Correct answer: D — Start guideline-concordant treatment and review benefit, burden and goals

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

D is correct. Palliative care does not preclude treatment of a reversible infection when benefit aligns with the patient’s goals; SBP requires prompt guideline-concordant assessment and antimicrobials, with ongoing proportionality review. A imposes therapeutic nihilism, B may undertreat a serious infection, and C and E introduce unsafe delays while awaiting microbiology.

Reference: NICE NG50: cirrhosis: https://www.nice.org.uk/guidance/ng50/chapter/Recommendations NICE NG142: end of life care service delivery: https://www.nice.org.uk/guidance/ng142/chapter/Recommendations