FREQUENCY OF PIPERACILLIN/TAZOBACTAM RESISTANCE IN SPONTANEOUS BACTERIAL PERITONITIS PATIENTS

M  IBRAHIM; M ASLAM; MU RAHMAN; SU RAHMAN; SU ZAMAN; MUK KHALIL

doi:10.54112/bcsrj.v2024i1.1158

Authors

M IBRAHIM Department of Gastroenterology, Lady Reading Hospital, Peshawar, Pakistan
M ASLAM Department of Gastroenterology, Lady Reading Hospital, Peshawar, Pakistan
MU RAHMAN Department of Gastroenterology, Lady Reading Hospital, Peshawar, Pakistan
SU RAHMAN Department of Gastroenterology, Lady Reading Hospital, Peshawar, Pakistan
SU ZAMAN Department of Gastroenterology, Lady Reading Hospital, Peshawar, Pakistan
MUK KHALIL Department of Gastroenterology, Lady Reading Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1158

Keywords:

Antibiotic resistance, Ascites, Chronic liver disease, Escherichia coli, Piperacillin/tazobactam, Spontaneous bacterial peritonitis, Tertiary care

Abstract

Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with chronic liver disease, requiring prompt antibiotic therapy. Due to growing resistance to first-line antibiotics like ceftriaxone, piperacillin/tazobactam is often used as a second-line treatment. However, emerging resistance to piperacillin/tazobactam poses a significant clinical challenge. Identifying local resistance patterns is crucial for optimizing treatment, particularly in resource-limited settings like Peshawar, Pakistan. Objective: To determine the frequency of piperacillin/tazobactam resistance among patients with spontaneous bacterial peritonitis at a tertiary care hospital in Peshawar, Pakistan. Methods: This cross-sectional study was conducted over five months at Lady Reading Hospital, Peshawar from 18th April to 18th September. A total of 169 patients aged 16 to 75 years with SBP secondary to chronic liver disease were included using non-probability consecutive sampling. Demographic and clinical data were collected, and ascitic fluid samples were cultured to assess resistance to piperacillin/tazobactam. Data were analyzed using descriptive statistics and chi-square tests to examine associations. A p-value < 0.05 was considered statistically significant. Results: Piperacillin/tazobactam resistance was found in 9.5% (16/169) of SBP patients. Resistance was observed in 8.0% (7/88) of Escherichia coli isolates and 11.1% (9/81) of other bacterial isolates (p = 0.04). Resistance rates were slightly higher in the 46–75 age group (11.0%, 11/100) compared to the 16–45 age group (7.3%, 5/69). Male patients had a resistance rate of 10.2% (11/108), while female patients showed 8.2% (5/61). Conclusion: This study highlights significant resistance to piperacillin/tazobactam among SBP patients in Peshawar, particularly in non-E. coli bacteria. These findings underline the need for personalized antibiotic regimens and ongoing surveillance to address growing antimicrobial resistance in chronic liver disease patients.

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