Bacterial infections in cirrhosis: Current treatment

Ann Hepatol. 2020 May-Jun;19(3):238-244. doi: 10.1016/j.aohep.2019.09.011. Epub 2019 Nov 21.

Abstract

Bacterial infections frequently cause decompensating events in cirrhotic patients and are also the most common factor identified for the development of acute-on-chronic liver failure (ACLF). The increase in the prevalence of infections caused by multidrug-resistant (MDR) microorganisms has resulted in the reduced effectiveness of empiric antimicrobial treatment. We conducted a PubMed search from the last 20 years using the Keywords cirrhosis; multidrug-resistant; infections; diagnosis; treatment; prophylaxis; monitoring; sepsis; nutrition and antibiotic resistant. We made a review about bacterial infections among cirrhotic patients; we mainly focus on the description of diagnostic tools; biomarkers; clinical scores for diagnosis and prognosis also; we made an analysis concerning the monitoring of cirrhotic patients with sepsis and finally made some recommendations about the treatment; prophylaxis and prevention.

Keywords: Acute-on-chronic liver failure; Cirrhosis; Liver; Multidrug-resistant; Sepsis.

Publication types

  • Review

MeSH terms

  • Acute-On-Chronic Liver Failure
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy
  • Bacterial Infections / diagnosis
  • Bacterial Infections / drug therapy*
  • Chemoprevention
  • Cross Infection / diagnosis
  • Cross Infection / drug therapy*
  • Drug Resistance, Multiple, Bacterial
  • Empyema / diagnosis
  • Empyema / drug therapy
  • Hepatic Encephalopathy
  • Hepatorenal Syndrome
  • Humans
  • Intensive Care Units
  • Liver Cirrhosis
  • Peritonitis / diagnosis
  • Peritonitis / drug therapy
  • Peritonitis / prevention & control
  • Pneumonia, Bacterial / diagnosis
  • Pneumonia, Bacterial / drug therapy
  • Sepsis / diagnosis
  • Sepsis / drug therapy*
  • Soft Tissue Infections / diagnosis
  • Soft Tissue Infections / drug therapy
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy

Substances

  • Anti-Bacterial Agents