1999. Cefpodoxime for Spontaneous Bacterial Peritonitis Prophylaxis: Incidence of Breakthrough Infection

Abstract Background Guidelines recommend use of fluoroquinolones and sulfamethoxazole-trimethoprim (SMX-TMP) for spontaneous bacterial peritonitis (SBP) prophylaxis based on data demonstrating a decrease in one-year incidence SBP. Our institution frequently utilizes cefpodoxime its favorable safety profile despite the lack robust clinical experience. We sought to compare rates breakthrough SBP with compared previously reported SMX-TMP fluoroquinolones. Methods This is an IRB-approved, retrospective, single-center cohort analysis. The electronic medical record at Hospital University Pennsylvania was utilized identify cirrhotic patients newly started from March 1, 2016, December 31, 2020. primary endpoint infections within 1 year who received or secondary prophylaxis. Secondary endpoints included 1-year all-cause mortality any microbiologic suspected confirmed during study timeframe. Descriptive statistics were analyze baseline characteristics collected points. Results Overall, 90 met inclusion criteria our population consisted mostly men (65.6%) mean age 59 years. majority taking (66.7%). A large proportion also had diabetes (44.4%). Alcohol (53.3%) most common cause cirrhosis, MELD score 20.3. Breakthrough occurred 4 (4.4%) out initiation. Of 19 completed full cefpodoxime, (5.2%) patient experienced Microbiologic significant growth Citrobacter spp., Streptococcus Enterococcus Candida glabrata. One culture-negative All-cause one 41.1%. Conclusion Cefpodoxime viable option comparable infection. does not appear encourage colonization infection resistant gram-negative pathogens. Disclosures All Authors: No disclosures.