First-line treatment with cephalosporins in spontaneous bacterial peritonitis provides poor antibiotic coverage

Novovic, Srdan; Semb, Synne; Olsen, Henrik; Moser, Claus; Knudsen, Jenny Dahl; Homann, Christian

doi:10.3109/00365521.2011.645502

Cited by 35 publications

(39 citation statements)

References 12 publications

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“…ESBL-E are predominant in Southern Europe and Asia [7,[13][14][15][16][17][18][19][20][21][22][23][24][25] , meanwhile MRSA and VRE are prevalent in the United States [26] . Carbapenemase-producing K. pneumoniae is a current problem described in some hospitals in Italy [27] .…”

Section: Diversity Of Mr Bacteria Types Across Countriesmentioning

confidence: 99%

“…Regular epidemiology assessment should be carried out in all centers and policies regarding empiric antibiotic treatment in cirrhosis should be updated and tailored according to the specific epidemiological pattern of 918 May 8, 2015|Volume 7|Issue 7| WJH|www.wjgnet.com [13,14,19,20,24] Italy, 8%-20% [17,21] Spain and United States, 6%-9% [7,15,26] France, Denmark and Germany, < 5% [22,23,25] MRSA Italy, 7% [17,21] United States, 5% [26] Spain, 3%-4% [7,15] France, 2% [23] Denmark, Germany, 0% [22,25] Pseudomonas aeruginosa Spain, South Korea, 2%-3% [7,[13][14][15]19,20,24] Germany, 1% [22] Denmark, France, 0% [23,25] VSE Denmark, 12% [25] Germany, 10% [22] France, 5% [23] Spain, 1%-7% [7,15] VRE United States, 9% [26] Spain, France, Denmark, Germany, 0% [7,15,22,23,25] ESBL: Extended-spectrum β-lactamase-producing Enterobacteriaceae (bacteria with chromosomal β-lactamases are also included); MRSA: Methicillinresistant Staphylococcus aureus; VSE: Vancomycin-susceptible Enterococcus; VRE: Vancom...…”

Section: Changing the Empirical Antibiotic Treatment Of Bacterial Infmentioning

confidence: 99%

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Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

Acevedo

2015

WJH

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Recently, important changes have been reported regarding the epidemiology of bacterial infections in liver cirrhosis. There is an emergence of multiresistant bacteria in many European countries and also worldwide, including the United States and South Korea. The classic empirical antibiotic treatment (third-generation cephalosporins, e.g. , ceftriaxone, cefotaxime or amoxicillin-clavulanic acid) is still effective in infections acquired in the community, but its failure rate in hospital acquired infections and in some health-care associated infections is high enough to ban its use in these settings. The current editorial focuses on the different epidemiology of bacterial infections in cirrhosis across countries and on its therapeutic implications.

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Section: Diversity Of Mr Bacteria Types Across Countriesmentioning

confidence: 99%

Section: Changing the Empirical Antibiotic Treatment Of Bacterial Infmentioning

confidence: 99%

Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

Acevedo

2015

WJH

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“…Although our data are referred to a single institution, poor antibiotic coverage provided by cephalosporines was observed also in studies conducted in countries with low prevalence of ESBL producing Enterobacteriaceae. 44 Candida spp should not be forgotten among the pathogens involved in LC related BSIs. Candidemia may arise both endogenously and exogenously in patients with LC, but nearly always occurs when a prolonged antibiotic exposure is documented.…”

Section: Etiologymentioning

confidence: 99%

Bloodstream infections in patients with liver cirrhosis

et al. 2016

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Bloodstream infections are a serious complication in patients with liver cirrhosis. Dysregulated intestinal bacterial translocation is the predominant pathophysiological mechanism of infections in this setting. For this reason enteric Gram-negative bacteria are commonly encountered as the first etiological cause of infection. However, through the years, the improvement in the management of cirrhosis, the recourse to invasive procedures and the global spread of multidrug resistant pathogens have importantly changed the current epidemiology. Bloodstream infections in cirrhotic patients are characterized by high mortality rate and complications including metastatic infections, infective endocarditis, and endotipsitis (or transjugular intrahepatic portosystemic shunt-related infection). For this reason early identification of patients at risk for mortality and appropriated therapeutic management is mandatory. Liver cirrhosis can significantly change the pharmacokinetic behavior of antimicrobials. In fact hypoproteinaemia, ascitis and third space expansion and impairment of renal function can be translated in an unpredictable drug exposure.

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“…Administration of 2 g intravenously twice a day is often preferred; a 5-day therapy is as effective as a 10-day therapy [Runyon et al 1991]. Alternatively piperacillin/tazobactam could be considered [Novovic et al 2012].…”

Section: Treatment Of Sbpmentioning

confidence: 99%

Management of cirrhotic ascites

Pedersen

Bendtsen

Möller

2015

Therapeutic Advances in Chronic Disease

108

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Abstract:The most common complication to chronic liver failure is ascites. The formation of ascites in the cirrhotic patient is caused by a complex chain of pathophysiological events involving portal hypertension and progressive vascular dysfunction. Since ascites formation represents a hallmark in the natural history of chronic liver failure it predicts a poor outcome with a 50% mortality rate within 3 years. Patients with ascites are at high risk of developing complications such as spontaneous bacterial peritonitis, hyponatremia and progressive renal impairment. Adequate management of cirrhotic ascites and its complications betters quality of life and increases survival. This paper summarizes the pathophysiology behind cirrhotic ascites and the diagnostic approaches, as well as outlining the current treatment options. Despite improved medical treatment of ascites, liver transplantation remains the ultimate treatment and early referral of the patient to a highly specialized hepatology unit should always be considered.

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First-line treatment with cephalosporins in spontaneous bacterial peritonitis provides poor antibiotic coverage

Cited by 35 publications

References 12 publications

Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

Bloodstream infections in patients with liver cirrhosis

Management of cirrhotic ascites

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