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

作　　者：Alberto Ferrarese Nicola Passigato Caterina Cusumano Stefano Gemini Angelo Tonon Elton Dajti Giovanni Marasco Federico Ravaioli Antonio Colecchia 

机构地区：[1]Department of Gastroenterology,Verona University Hospital,Verona 37124,Italy [2]Department of Medical and Surgical Sciences,University of Bologna,Bologna 40138,Italy

出　　处：《World Journal of Hepatology》2021年第8期840-852,共13页世界肝病学杂志（英文版）（电子版）

摘　　要：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 quinolonesrelated 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.

关 键 词：CIRRHOSIS QUINOLONES Spontaneous bacterial peritonitis Liver transplantation Trans-jugular intrahepatic portosystemic shunt Variceal bleeding 

分 类 号：R575.2[医药卫生—消化系统]