Antibiotics and Liver Cirrhosis: What the Physicians Need to Know

Zoratti, Caterina; Moretti, Rita; Rebuzzi, Lisa; Albergati, Irma Valeria; Somma, Antonietta Di; Decorti, Giuliana; Bella, Stefano Di; Crocè, Lory Saveria; Giuffrè, Mauro

doi:10.3390/antibiotics11010031

Cited by 18 publications

(19 citation statements)

References 150 publications

(210 reference statements)

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“…In patients with liver cirrhosis, some antibiotics have shown to contribute to renal failure, gastrointestinal bleeding, spontaneous bacterial peritonitis, and encephalopathy. Hence, factors to be considered when handling cirrhotic patients with infections include drugs pharmacokinetics, pharmacodynamics, hepatotoxicity, and likelihood of side effects [ 149 ]. The drug dosing should be modified depending on nutritional status, kidney function, adherence, and drug interaction.…”

Section: Therapeutic Gut–microbiome Interactionmentioning

confidence: 99%

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Trust Your Gut: The Association of Gut Microbiota and Liver Disease

et al. 2022

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The gut microbiota composition is important for nutrient metabolism, mucosal barrier function, immunomodulation, and defense against pathogens. Alterations in the gut microbiome can disturb the gut ecosystem. These changes may lead to the loss of beneficial bacteria or an increase in potentially pathogenic bacteria. Furthermore, these have been shown to contribute to the pathophysiology of gastrointestinal and extra-intestinal diseases. Pathologies of the liver, such as non-alcoholic liver disease, alcoholic liver disease, cirrhosis, hepatocellular carcinoma, autoimmune hepatitis, viral hepatitis, and primary sclerosing cholangitis have all been linked to changes in the gut microbiome composition. There is substantial evidence that links gut dysbiosis to the progression and complications of these pathologies. This review article aimed to describe the changes seen in the gut microbiome in liver diseases and the association between gut dysbiosis and liver disease, and finally, explore treatment options that may improve gut dysbiosis in patients with liver disease.

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Section: Therapeutic Gut–microbiome Interactionmentioning

confidence: 99%

“…The drug dosing should be modified depending on nutritional status, kidney function, adherence, and drug interaction. The most significant factor to consider is to diagnose an infection early and to start with an appropriate antibiotic regimen when dealing with cirrhotic patients [ 149 ].…”

Section: Therapeutic Gut–microbiome Interactionmentioning

confidence: 99%

Trust Your Gut: The Association of Gut Microbiota and Liver Disease

et al. 2022

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“…The liver metabolises xenobiotics as the body’s first line of defense against ingested toxins and drugs, which often cause necrosis and apoptosis ( Tsochatzis et al, 2014 ). A growing body of research focuses on the potential toxicity of antibiotics in the liver ( Acevedo, 2015 ; Fernández et al, 2016 ; Zoratti et al, 2022 ). Vancomycin tends to cause adverse events after prolonged use, and large doses may be toxic to the liver ( Kucukler et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Protective role of resveratrol against VCM-induced hepatotoxicity in male wistar rats

Alshehri

Alorfi²

2023

Front. Pharmacol.

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Background: Vancomycin is a glycopeptide antibiotic with a high risk of acute liver injury. Resveratrol is believed to protect the liver against toxicity.Aim: To investigate the ability of resveratrol to attenuate vancomycin-induced liver toxicity in rats injected with vancomycin.Method: Twenty-four adult male Wistar rats were distributed into three groups. The control group received only a vehicle, while the treated group received either vancomycin 200 (mg/kg, i. p.) only or vancomycin (200 mg/kg, i. p.) with resveratrol (20 mg/kg, oral gavage). All groups received their dose once daily for 7 days. Hepatic damage was assessed by measuring biochemical parameter levels in serum, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH). Also, antioxidants and inflammation biomarkers such as Interleukin-6 (IL-6), malondialdehyde (MDA), nitric oxide (NO), and glutathione (GSH) were measured. Furthermore, the vancomycin-induced pathological changes in the liver were evaluated by histopathological studies.Results: In the vancomycin-treated group, hepatic serum biomarkers such as AST, ALT, ALP, IL-6, and MDA were elevated, while NO and GSH were depleted. However, resveratrol co-treatment with vancomycin prevented the elevation of AST, ALT, ALP, IL-6, and MDA and it protected the liver from NO and GSH depletion. Also, regarding vancomycin-induced degeneration of hepatocytes, resveratrol co-treatment with vancomycin prevented such degeneration and improved mononuclear cells in the liver.Conclusion: The results showed that oral administration of resveratrol has a significant hepatoprotective effect against vancomycin-induced hepatotoxicity.

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“…Said performance may be affected by the emergence of cor pulmonale due to hypoxia, one of the primary reasons of ECMO implementation [6][7][8]. Fluid resuscitation can further exacerbate venous liver congestion [77,78]. The significant increase in fluid balance results in excessive mortality in ECMO [74].…”

Section: Critical Care Illness-induced Changes In Antibiotics Levelsmentioning

confidence: 99%

Antibiotics and ECMO in the Adult Population—Persistent Challenges and Practical Guides

2022

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Extracorporeal membrane oxygenation (ECMO) is an emerging treatment modality associated with a high frequency of antibiotic use. However, several covariables emerge during ECMO implementation, potentially jeopardizing the success of antimicrobial therapy. These variables include but are not limited to: the increased volume of distribution, altered clearance, and adsorption into circuit components, in addition to complex interactions of antibiotics in critical care illness. Furthermore, ECMO complicates the assessment of antibiotic effectiveness as fever, or other signs may not be easily detected, the immunogenicity of the circuit affects procalcitonin levels and other inflammatory markers while disrupting the immune system. We provided a review of pharmacokinetics and pharmacodynamics during ECMO, emphasizing practical application and review of patient-, illness-, and ECMO hardware-related factors.

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Antibiotics and Liver Cirrhosis: What the Physicians Need to Know

Cited by 18 publications

References 150 publications

Trust Your Gut: The Association of Gut Microbiota and Liver Disease

Trust Your Gut: The Association of Gut Microbiota and Liver Disease

Protective role of resveratrol against VCM-induced hepatotoxicity in male wistar rats

Antibiotics and ECMO in the Adult Population—Persistent Challenges and Practical Guides

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