Ascites and antibiotics

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  • June 18, 2013 at 2:16 am #72964
    pcl1029
    Member

    Hi,

    Ascites in patient with liver diseases is more related to the portal vein hypertension because the tumors obstruct or compress the portal veins. Starting doses of diuretics are Lasix up to 40mg/day and Aldactone up to 100mg/day. These doses should be adjusted upward (while maintaining this ratio) to achieve natriuresis and weight loss.–uptodate.com.

    God bless.

    June 18, 2013 at 2:06 am #72963
    pcl1029
    Member

    Hi,
    After reading an article, there are no indication for using antibiotics unless patient has fever at diagnosis.
    Therefore I believe to prescribe antibiotics BEFORE the evaluation of the content of the ascites fluid and the possible elevated neutrophil count in the fluid is more for PROPHYLAXIS purpose than the standard treatment protocol.

    God bless.

    June 18, 2013 at 1:51 am #72962
    lindar
    Spectator

    Here’s a little more background. He has been having fevers and was sent to the ER last week. They did blood and urine tests, chest XRay, etc. but everything was negative. His blood counts were actually pretty good. However, his liver enzymes were elevated. I’m having trouble understanding how all this is related. Do ascites mean that the cancer has progressed or can they also be related to a decrease in liver function, possibly caused by chemo?

    June 18, 2013 at 1:45 am #72961
    dmj4ctj
    Member

    Hi Linda,
    I did a google search of ascites and antibiotic treatment. I found out that if a patients WBC count is high, a bacterial infection may be responsible and antibiotics are indicated. I didn’t know about this either, and you got me curious. Wishing for the best for you guys.
    Dianne

    June 18, 2013 at 1:41 am #72960
    willow
    Spectator

    I don’t understand either unless the Dr believes its from an infection (like peritonitis) causing more fluid.

    June 18, 2013 at 1:16 am #8513
    lindar
    Spectator

    My husband received a call from the oncologist’s nurse today about his CT scan results. The good news is that the tumors in his liver have not changed. However, the scan indicated that he has fluid in his abdomen. (His past scans showed mild ascites but the amount of fluid has increased.) The nurse said that the doctor wants him to start antibiotics immediately as he hopes they may take care of the problem. Does anyone understand how antibiotics could reduce ascites? I can’t understand the connection.

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