Proton pump inhibitors and their relation to spontaneous bacterial peritonitis in patients with cirrhosis and ascites: An evidenced-based case report

Introduction: Despite being one of five medicines commonly prescribed in the United States, PPI use is deemed controversial for patients with cirrhosis. The purpose of this study is to find out causality between administrations of PPI in cirrhosis patients with ascites with incidences of SBP. Methods: A structured internet literature searching was conducted by using Cochrane, PubMed®, ClinicalKey®, and Ebsco®. After screening titles and abstracts by inclusion and exclusion criteria, 13 original articles were found, but only 1 article was used. This meta-analysis is critically appraised for its validity, importance, and applicability. Results: PPI use in patients with cirrhosis and ascites had significant difference with an increased risk of SBP [OR= 2.17; 95% CI = 1.46–3.23; P < 0.05] with heterogeneity study [I²= 85.6%]. Conclusion: PPI in patients with cirrhosis and ascites increases two times the risk of SBP.