Patients with cirrhosis show an increased susceptibility to infection due to disease-related immune-dysfunction. Bacterial infection therefore represents a common, often detrimental event in patients with advanced liver disease, since it can worsen portal hypertension and impair the function of hepatic and extrahepatic organs. Among pharmacological strategies to prevent infection, antibiotic prophylaxis remains the first-choice, especially in high-risk groups, such as patients with acute variceal bleeding, low ascitic fluid proteins, and prior episodes of spontaneous bacterial peritonitis. Nevertheless, antibiotic prophylaxis has to deal with the changing bacterial epidemiology in cirrhosis, with increased rates of gram-positive bacteria and multidrug resistant rods, warnings about quinolones-related side effects, and low prescription adherence. Short-term antibiotic prophylaxis is applied in many other settings during hospitalization, such as before interventional or surgical procedures, but often without knowledge of local bacterial epidemiology and without strict adherence to antimicrobial stewardship. This paper offers a detailed overview on the application of antibiotic prophylaxis in cirrhosis, according to the current evidence.

Antibiotic prophylaxis in patients with cirrhosis: Current evidence for clinical practice / Ferrarese, A.; Passigato, N.; Cusumano, C.; Gemini, S.; Tonon, A.; Dajti, E.; Marasco, G.; Ravaioli, F.; Colecchia, A.. - In: WORLD JOURNAL OF HEPATOLOGY. - ISSN 1948-5182. - 13:8(2021), pp. 840-852. [10.4254/wjh.v13.i8.840]

Antibiotic prophylaxis in patients with cirrhosis: Current evidence for clinical practice

Colecchia A.
2021

Abstract

Patients with cirrhosis show an increased susceptibility to infection due to disease-related immune-dysfunction. Bacterial infection therefore represents a common, often detrimental event in patients with advanced liver disease, since it can worsen portal hypertension and impair the function of hepatic and extrahepatic organs. Among pharmacological strategies to prevent infection, antibiotic prophylaxis remains the first-choice, especially in high-risk groups, such as patients with acute variceal bleeding, low ascitic fluid proteins, and prior episodes of spontaneous bacterial peritonitis. Nevertheless, antibiotic prophylaxis has to deal with the changing bacterial epidemiology in cirrhosis, with increased rates of gram-positive bacteria and multidrug resistant rods, warnings about quinolones-related side effects, and low prescription adherence. Short-term antibiotic prophylaxis is applied in many other settings during hospitalization, such as before interventional or surgical procedures, but often without knowledge of local bacterial epidemiology and without strict adherence to antimicrobial stewardship. This paper offers a detailed overview on the application of antibiotic prophylaxis in cirrhosis, according to the current evidence.
2021
13
8
840
852
Antibiotic prophylaxis in patients with cirrhosis: Current evidence for clinical practice / Ferrarese, A.; Passigato, N.; Cusumano, C.; Gemini, S.; Tonon, A.; Dajti, E.; Marasco, G.; Ravaioli, F.; Colecchia, A.. - In: WORLD JOURNAL OF HEPATOLOGY. - ISSN 1948-5182. - 13:8(2021), pp. 840-852. [10.4254/wjh.v13.i8.840]
Ferrarese, A.; Passigato, N.; Cusumano, C.; Gemini, S.; Tonon, A.; Dajti, E.; Marasco, G.; Ravaioli, F.; Colecchia, A.
File in questo prodotto:
File Dimensione Formato  
WJH-13-840.pdf

Open access

Tipologia: Versione pubblicata dall'editore
Dimensione 718.82 kB
Formato Adobe PDF
718.82 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1280928
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 2
social impact