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Evaluation of Safety & Efficacy of Synbiotic on the Incidence and Recurrence of Spontaneous Bacterial Peritonitis (SBP) in Cirrhotics

G

Govind Ballabh Pant Hospital

Status and phase

Completed
Phase 3

Conditions

Cirrhosis With Ascites

Treatments

Drug: Norfloxacin + Synbiotic
Drug: Norfloxacin + Placebo

Study type

Interventional

Funder types

Other

Identifiers

NCT00947336
2009-PHT-01

Details and patient eligibility

About

Background: Spontaneous bacterial peritonitis (SBP) is a serious complication in patients of cirrhosis with ascites and may occur despite antibiotic prophylaxis. Small bowel dysmotility and bacterial overgrowth have been documented to be related to SBP. Aims: To investigate whether addition of prebiotic plus probiotics (synbiotics) to norfloxacin enhances the efficacy of norfloxacin in prevention of SBP in high risk patients with ascites.

Methods: A prospective, double blind, randomized controlled trial was conducted in consecutive high-risk cirrhotic patients with ascites who had either recovered from an episode of SBP (secondary prophylaxis) or who never had SBP but were at high risk for development of SBP (low ascitic fluid protein or serum bilirubin ≥2.5 mg/dL; primary prophylaxis). Norfloxacin 400 mg once daily with synbiotic capsules (Streptococcus faecalis JPC 30 million, Clostridium butyricum 2 million, Bacillus mesentericus JPC 1 million, Lactobacillus sporogenes 50 million spores) 2 t.i.d. (group I) or norfloxacin 400 mg once daily with placebo (group II) was given and occurrence of SBP within a period of 6 months (primary endpoint) or side-effects of therapy and mortality (secondary endpoints) were recorded. Every patient received IV albumin to maintain a serum albumin level of >3.2 g/dl. SBP was treated with intravenous antibiotics with albumin.

Enrollment

110 patients

Sex

All

Ages

12 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Cirrhosis with ascites with any one of following:

    • History of at least one episode of SBP, or
    • Ascitic fluid protein less than or equal to 1g/dL, or
    • Serum bilirubin more than or equal to 2.5 mg/dL

Exclusion criteria

  • Renal failure
  • HCC
  • Hepatic encephalopathy
  • No consent

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Single Group Assignment

Masking

Double Blind

110 participants in 2 patient groups, including a placebo group

Norfloxacin + Synbiotic
Active Comparator group
Treatment:
Drug: Norfloxacin + Synbiotic
Norfloxacin + Placebo
Placebo Comparator group
Treatment:
Drug: Norfloxacin + Placebo

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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