Dirchwolf M, Gomez Perdiguero G, Grech IM, Marciano S. Challenges and recommendations when selecting empirical antibiotics in patients with cirrhosis. World J Hepatol 2023; 15(3): 377-385 [PMID: 37034233 DOI: 10.4254/wjh.v15.i3.377]
Corresponding Author of This Article
Sebastian Marciano, MD, MSc, Academic Research, Associate Research Scientist, Chief Doctor, Liver Unit and Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, Buenos Aires 1181, Argentina. sebastian.marciano@hospitalitaliano.org.ar
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Mar 27, 2023; 15(3): 377-385 Published online Mar 27, 2023. doi: 10.4254/wjh.v15.i3.377
Challenges and recommendations when selecting empirical antibiotics in patients with cirrhosis
Melisa Dirchwolf, Gonzalo Gomez Perdiguero, Ingrid Mc Grech, Sebastian Marciano
Melisa Dirchwolf, Ingrid Mc Grech, Liver Unit, Hospital Privado de Rosario, Rosario 2000, Santa Fe, Argentina
Gonzalo Gomez Perdiguero, Liver Unit, Hospital Italiano de Buenos Aires, Buenos Aires 1181, Argentina
Sebastian Marciano, Liver Unit and Department of Research, Hospital Italiano de Buenos Aires, Buenos Aires 1181, Argentina
Author contributions: All authors performed the literature research, wrote and revised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sebastian Marciano, MD, MSc, Academic Research, Associate Research Scientist, Chief Doctor, Liver Unit and Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, Buenos Aires 1181, Argentina. sebastian.marciano@hospitalitaliano.org.ar
Received: November 12, 2022 Peer-review started: November 12, 2022 First decision: November 23, 2022 Revised: December 28, 2022 Accepted: March 10, 2023 Article in press: March 10, 2023 Published online: March 27, 2023
Core Tip
Core Tip: Practitioners who participate in caring for patients with cirrhosis are challenged when using antibiotics rationally. On one side, bacterial infections are frequent, severe, and not always straightforward to diagnose; on the other, scant granular data is publicly available about the causal microorganisms and their susceptibility patterns. According to experts, empiric antibiotic treatments should cover 80% of the common pathogens in stable patients and 90% in critically ill patients with suspected infections. Therefore, it is necessary to know the microorganisms expected to be involved in the most frequent bacterial infections and their susceptibility patterns to develop evidence-based guidelines. This opens a window of opportunity for research because bacterial infections and multidrug resistance are global health issues expected to grow over the following decades.
