When should I consider referring a patient with SBP to secondary care for further management?

You should consider referring a patient with suspected spontaneous bacterial peritonitis (SBP) to secondary care for further management if they show signs of decompensated liver disease NICE CKS. Suspected SBP is a serious complication of cirrhosis and indicates decompensation NICE CKS.

Specifically, you should arrange emergency hospital admission or an immediate referral to a hepatologist or gastroenterologist with an interest in hepatology, based on clinical judgement NICE CKS.

Specialist treatment with prophylactic antibiotics to prevent SBP may also be considered for individuals with ascites who are at high risk of infection, or where the consequences of infection could severely impact their outcome and care NICE CKS.