P-68 Frequency and Factors Associated With Antibiotic De-Escalation in Patients With Cirrhosis and Bacterial Infections

Acevedo, Maria Nelly Gutierrez; Barbero, Sabrina; Notari, Lorena del Carmen; Agozino, Marina; Fernández, José Luis Fernández; Tevez, Silvina; Anders, Maria Margarita; Grigera, Nadia; Antinucci, Florencia; Ganem, Orlando Orozco; Murga, Maria Dolores; Perez, Daniea; Palazzo, Ana; Rejtman, Liria Martinez; Duarte, Ivonne Giselle; Vorobioff, Julio; Trevizan, Victoria; Bulaty, Sofía; Bessone, Fernando; Bosia, José Daniel; Borzi, Silvia; Stieben, Teodoro E.; Masola, Adriano; Ferretti, Sebastian Eduardo; Ramos, Agñel; Arufe, Diego; Demirdjian, Ezequiel; Raffa, Maria Pia; Vazquez, Cintia Elizabet; Ruiz, Pablo; Martínez, José Emanuel; Fainboim, Hugo; Peralta, Mirta; Heffner, Leandro Alfredo; Odzak, Andrea; Bruno, Andrés; Dirchwolf, Melisa; Tomatis, Jesica; Smud, Astrid; Mendizábal, Manuel; Pages, Josefina; Bellizzi, Carla; Martínez, Ana Almansa; Giunta, Diego; Valverde, Marcelo; Elizondo, Martín; Mauro, Ezequiel; Gadano, Adrián; Marciano, Sebastián

doi:10.1016/j.aohep.2021.100431

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“…Therefore, scientific societies or governmental organizations should implement and lead these programs and report their results at different levels. For example, Argentina and Uruguay launched a surveillance program for bacterial infections in patients with cirrhosis in October 2018, which hepatologists, infectious diseases, and epidemiologists lead and aims to serve as a platform to perform evidence-based recommendations regarding empirical antibiotic selection in this population[ 50 ].…”

Section: Introductionmentioning

confidence: 99%

Challenges and recommendations when selecting empirical antibiotics in patients with cirrhosis

Dirchwolf¹,

Perdiguero²,

Grech³

et al. 2023

World J Hepatol

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There is abundant evidence that bacterial infections are severe complications in patients with cirrhosis, being the most frequent trigger of acute-on-chronic liver failure and causing death in one of every four patients during hospitalization. For these reasons, early diagnosis and effective treatment of infections are mandatory to improve patient outcomes. However, treating physicians are challenged in daily practice since diagnosing bacterial infections is not always straightforward. This situation might lead to delayed antibiotic initiation or prescription of ineffective regimens, which are associated with poor outcomes. On the other hand, prescribing broad-spectrum antibiotics to all patients suspected of bacterial infections might favor bacterial resistance development. This is a significant concern given the alarming number of infections caused by multidrug-resistant microorganisms worldwide. Therefore, it is paramount to know the local epidemiology to propose tailored guidelines for empirical antibiotic selection in patients with cirrhosis in whom bacterial infections are suspected or confirmed. In this article, we will revise current knowledge in this area and highlight the importance of surveillance programs.

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Section: Introductionmentioning

confidence: 99%