Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 8, 2015; 7(7): 916-921
Published online May 8, 2015. doi: 10.4254/wjh.v7.i7.916
Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies
Juan Acevedo
Juan Acevedo, Department of Gastroenterology and Hepatology, Queen Alexandra Hospital, PO6 3LY Portsmouth, United Kingdom
Author contributions: Acevedo J solely contributed to this paper.
Conflict-of-interest: Nothing to declare.
Open-Access: 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/
Correspondence to: Juan Acevedo, MD, PhD, Department of Gastroenterology and Hepatology, Queen Alexandra Hospital, Southwick Hill Road, PO6 3LY Portsmouth, United Kingdom. juan.acevedo@porthosp.nhs.uk
Telephone: +44-23-92286000-1210 Fax: +44-23-92286822
Received: January 13, 2015
Peer-review started: January 15, 2015
First decision: January 20, 2015
Revised: February 13, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: May 8, 2015

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.

Keywords: Bacterial infections, Multiresistant bacteria, Antibiotic, Liver cirrhosis

Core tip: There is a growing prevalence of multiresistant bacteria in nosocomial and in health-care associated settings worldwide. Nowadays, it is necessary that all liver units assess the presence of antibiotic resistance in their population. The classical empirical antibiotic therapy, third generation cephalosporins, can no longer be employed in areas with high prevalence of multiresistant bacterial infections. The current editorial focuses on the different patterns of resistance across countries and on its therapeutic implications.