Continuous infusion of beta-lactam antibiotics in cirrhotic patients with bloodstream infection: results from a prospective multicentre observational study

Bartoletti, Michele; Giannella, Maddalena; Lewis, Russell E.; Tedeschi, Sara; Verucchi, G; Caraceni, Paolo; Cerenzia, M. Torrani; Seminari, Elena; Bruns, Tony; Merli, Manuela; Burra, P.; Maraolo, Alberto Enrico; Schramm, C; Cobos-Tigueros, N.; Paul, Manju; Rodríguez‐Baño, Jesús; Bernardi, M.; Viale, Pierluigi

doi:10.1016/s0168-8278(18)30307-6

Cited by 2 publications

(3 citation statements)

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“…In fact, considering that beta-lactams are time dependent antibiotics (i.e., the efficacy depends on the time the concentration is above the minimal inhibitory concentration [MIC]) and have short half-life, an extended/continuous infusion strategy can enhance the time above the MIC. Recently, this strategy was associated with improved survival in patients with cirrhosis and bloodstream infections [ 39 ].…”

Section: Management Of Bacterial Infectionsmentioning

confidence: 99%

Changes in the epidemiology and management of bacterial infections in cirrhosis

2021

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Patients with cirrhosis are susceptible to develop infections because of immune dysfunction, changes in microbiome and increase in bacterial translocation from the gut to systemic circulation. Bacterial infections can worse the clinical course of the disease, triggering the development of complications such as acute kidney injury, hepatic encephalopathy, organ failures and acute on chronic liver failure. In recent years, the spread of multi drug resistant bacteria made more challenging the management of infections in patients with cirrhosis. Hence, the mortality rate associated to sepsis is increasing in these patients. Therefore, the optimization of the management of infections has a high priority in cirrhosis. Herein we reviewed the recent changes in the epidemiology and the management of bacterial infections in patients with liver cirrhosis.

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Section: Management Of Bacterial Infectionsmentioning

confidence: 99%

Changes in the epidemiology and management of bacterial infections in cirrhosis

2021

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“…In this setting, Merli et al found a broad-spectrum treatment associated with a lower mortality rate 38 . Finally, extended/continuous infusion of beta-lactam antibiotics should be considered, since it may increase the time of plasma antibiotic concentration above the minimal inhibitory concentration and has been associated with better survival in patients with cirrhosis and bloodstream infections 69 …”

Section: Treatment Of Infectionsmentioning

confidence: 99%

“…38 Finally, extended/ continuous infusion of beta-lactam antibiotics should be considered, since it may increase the time of plasma antibiotic concentration above the minimal inhibitory concentration and has been associated with better survival in patients with cirrhosis and bloodstream infections. 69 Whenever microbiological cultures allow identification of bacteria responsible for infections, antibiotic therapy should be modified according to the antimicrobial susceptibility tests. 2 In those with negative cultures, antibiotic treatment should be adapted to clinical course.…”

Section: Antibiotic Treatmentmentioning

confidence: 99%

Bacterial Infections in Cirrhosis

Tonon

Angeli

Piano

2021

Infectious Microbes and Diseases

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Bacterial infections are the most common trigger of acute decompensation of cirrhosis. The occurrence of infections in cirrhosis is associated with the development of organ dysfunctions, failures, and acute on chronic liver failure. The combination of infections and organ dysfunction/acute on chronic liver failure dramatically increases the mortality risk in these patients. Infections in cirrhosis are a big challenge for clinicians, since the mortality from sepsis is increasing in these patients worldwide. The rapid and progressive spread of multiresistant bacteria has been blamed for the increased mortality rate. Several studies have shown that early diagnosis and appropriate administration of antibiotic treatment are crucial for improving prognosis in these patients. Moreover, the prevention and treatment of acute kidney injury and organ failures are fundamental parts of management of infections in cirrhosis. Herein we provided a concise and updated review of the literature on bacterial infections in patients with cirrhosis.

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Continuous infusion of beta-lactam antibiotics in cirrhotic patients with bloodstream infection: results from a prospective multicentre observational study

Cited by 2 publications

References 0 publications

Changes in the epidemiology and management of bacterial infections in cirrhosis

Changes in the epidemiology and management of bacterial infections in cirrhosis

Bacterial Infections in Cirrhosis

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