الفهرس 
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Abstract
Spontaneous Bacterial Peritonitis is ominous complication in patients with cirrhosis and ascites , it is infection of previously sterile ascitic fluid in which: (a)the ascitic fluid culture grows bacteria. (b)the ascitic fluid neutrophil count is >250 cells/mm3, (c)there is no intra abdominal source of infection.
Ascitic fluid culture has an important role in the diagnosis and management of SBP, Rapid diagnosis and treatment play a key role in the management of SBP. In general, potentially fatal cirrhosis-related infectious disease is diagnosed based only on an increased PMN count in the ascitic fluid, but inoculation of the ascitic fluid into blood culture bottles at the patient’s bedside resulted in more rapid detection of bacterial growth, increase the sensitivity of the bacterial culture , and it is superior to inoculation of the ascitic fluid into conventional culture , the insensitivity of the conventional method is probably due to the low concentration of bacteria in infected ascites and the small volume of ascites cultured by this method.
In our study 3rd generation cephalosporins(commonly used cefotax) became not a good initial choice for SBP treatment.
Conclusion
Ascitic fluid culture in blood culture bottles and cytological examination of ascitic fluid must be carried-out routinely in every case of cirrhotic ascites to detect SBP or one of its variants in view of the high prevalence of this complication in such patients,especially those with more advanced liver disease,broad-spectrum cephalosporins became not a good initial choice for SBP treatment.