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Albumin in SBP Survival — SCE Infectious Diseases MCQ

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EasyHealthcare-Associated InfectionsAlbumin in SBP SurvivalSCE Infectious Diseases

A 50-year-old man with cirrhosis and ascites develops a temperature of 38.5°C with abdominal pain. Diagnostic paracentesis shows 450 neutrophils/µL. Gram stain shows Gram-negative rods. He starts IV Ceftriaxone. In addition to antibiotics, what other treatment improves survival in SBP?

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Correct answer: D — IV Albumin 1.5 g/kg on day 1 and 1 g/kg on day 3 — albumin reduces the incidence of hepatorenal syndrome and improves survival in SBP

The Sort et al. trial (1999, NEJM) demonstrated that IV albumin administered alongside antibiotics for SBP significantly reduced the incidence of hepatorenal syndrome (from 33% to 10%) and improved in-hospital survival. The dose is 1.5 g/kg on day 1 and 1 g/kg on day 3. This benefit is most pronounced in patients with bilirubin >68 µmol/L or creatinine >88 µmol/L. Albumin expands plasma volume and may have additional anti-inflammatory/endothelial-protective effects.

Reference: EASL 2024 – SBP; BSG 2021 – Ascites; Sort et al. 1999 NEJM