Antibiotic prophylaxis during bleeding for portal hypertension: authors’ reply

Chavez-Tapia, Norberto C; Barrientos‐Gutiérrez, Tonatiuh; Téllez-Ávila, Félix Ignacio; Soares‐Weiser, Karla; Méndez-Sánchez, Nahúm; Gluud, Christian; Uribe, Misael

doi:10.1111/j.1365-2036.2011.04819.x

Cited by 3 publications

(6 citation statements)

References 6 publications

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“…Additionally, targeting gut microbial metabolites and their receptors may offer novel therapeutic options for the management of portal hypertension [40,43]. In fact, bacterial-derived products may increase hyperdynamic circulation and intrahepatic vascular resistance, promoting a further increase in portal pressure and the risk of bleeding [44][45][46].…”

Section: Antibiotic Effects On Portal Hypertensionmentioning

confidence: 99%

Antibiotics in Chronic Liver Disease and Their Effects on Gut Microbiota

Mendez-Sanchez,

Coronel-Castillo,

Cordova-Gallardo

et al. 2023

Antibiotics

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Impairments in liver function lead to different complications. As chronic liver disease progresses (CLD), hypoalbuminemia and alterations in bile acid compositions lead to changes in gut microbiota and, therefore, in the host–microbiome interaction, leading to a proinflammatory state. Alterations in gut microbiota composition and permeability, known as gut dysbiosis, have important implications in CLD; alterations in the gut–liver axis are a consequence of liver disease, but also a cause of CLD. Furthermore, gut dysbiosis plays an important role in the progression of liver cirrhosis and decompensation, particularly with complications such as hepatic encephalopathy and spontaneous bacterial peritonitis. In relation to this, antibiotics play an important role in treating CLD. While certain antibiotics have specific indications, others have been subjected to continued study to determine whether or not they have a modulatory effect on gut microbiota. In contrast, the rational use of antibiotics is important, not only because of their disrupting effects on gut microbiota, but also in the context of multidrug-resistant organisms. The aim of this review is to illustrate the role of gut microbiota alterations in CLD, the use and impact of antibiotics in liver cirrhosis, and their harmful and beneficial effects.

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Section: Antibiotic Effects On Portal Hypertensionmentioning

confidence: 99%

Antibiotics in Chronic Liver Disease and Their Effects on Gut Microbiota

Mendez-Sanchez,

Coronel-Castillo,

Cordova-Gallardo

et al. 2023

Antibiotics

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“…(84) We recommend prophylactic antibiotics given potential reduction in rates of rebleeding and bacterial infections. (85)…”

Section: Variceal Bleedingmentioning

confidence: 99%

“…Following an episode of gastrointestinal bleeding, antibiotic prophylaxis is currently recommended (86) as it decreases the risk of infection, rebleeding, and infection-related and allcause mortality. (85,87) Most studies evaluated 7 days of antibiotic therapy, but in patients with rapid control of bleeding and less severe liver disease, shorter-course therapy may be acceptable. When administering antibiotic prophylaxis after gastrointestinal bleeding (GIB), the majority of studies used norfloxacin 400 mg orally twice daily or ceftriaxone 1 g IV daily.…”

Section: Infectious Disordersmentioning

confidence: 99%

“…When administering antibiotic prophylaxis after gastrointestinal bleeding (GIB), the majority of studies used norfloxacin 400 mg orally twice daily or ceftriaxone 1 g IV daily. (85,88) In patients with more advanced liver disease with at least 2 of the following-ascites, HE, jaundice, or severe malnutrition-superior results were achieved with IV ceftriaxone. (14,89) Primary SBP prophylaxis should be considered in highly selected patients: ascitic fluid total protein < 1.5 g/dL and AKI (sCr 1.2 mg/dL, blood urea nitrogen 25 mg/dL, or serum Na 130 mEq/ L) or Child-Turcotte-Pugh 9 with serum bilirubin 3 mg/dL.…”

Section: Infectious Disordersmentioning

confidence: 99%

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Critical care management of the patient with cirrhosis awaiting liver transplant in the intensive care unit

Olson

Karvellas

2017

Liver Transpl

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Patients with cirrhosis who are awaiting liver transplantation (LT) are at high risk for developing critical illnesses. Current liver allocation policies that dictate a "sickest first" approach coupled with a mismatch between need and availability of organs result in longer wait times, and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well-compensated cirrhosis may suffer acute deterioration; the syndrome of acute-on-chronic liver failure (ACLF) results in multisystem organ dysfunction and a marked increase in associated short-term morbidity and mortality. For patients on transplant waiting lists, the development of multisystem organ failure may eliminate candidacy for transplant by virtue of being "too sick" to safely undergo transplantation surgery. The goals of intensive care management of patients suffering ACLF are to rapidly recognize and treat inciting events (eg, infection and bleeding) and to aggressively support failing organ systems to ensure that patients may successfully undergo LT. Management of the critically ill ACLF patient awaiting transplantation is best accomplished by multidisciplinary teams with expertise in critical care and transplant medicine. Such teams are well suited to address the needs of this unique patient population and to identify patients who may be too ill to proceed to transplantation surgery. The focus of this review is to identify the common complications of ACLF and to describe our approach management in critically ill patients awaiting LT in our centers. Liver Transplantation 23 1465-1476 2017 AASLD.

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“…1,2,4 Antibiotic prophylaxis reduces the incidence of bacterial infections to 10-20%, improves control of bleeding, decreases rebleeding and increases survival. 1,2,5 Based on these confirmed benefits, antibiotic prophylaxis is a component of the standard of care for patients with AVB and should be initiated on admission to hospital. 6,7 However, adherence to antibiotic prophylaxis recommendations in some recent series was lower than 50%.…”

Section: Introductionmentioning

confidence: 99%