{Reference Type}: Journal Article
{Title}: Towards evidence-based empiric antibiotic recommendations for spontaneous infections in patients with cirrhosis.
{Author}: Dirchwolf M;Gomez Perdiguero G;Cairo F;Vazquez C;Notari L;Murga MD;Elizondo M;Bessone F;Agozino M;Brutti J;Zerega AR;Pages J;Stieben TE;Calzetta P;Arufe D;González Ballerga E;Giunta D;Smud A;Osso Sanchez B;Navarro L;Palazzo A;Valverde M;Gadano A;Marciano S;
{Journal}: Dig Liver Dis
{Volume}: 0
{Issue}: 0
{Year}: 2024 Aug 5
{Factor}: 5.165
{DOI}: 10.1016/j.dld.2024.07.023
{Abstract}: <B>BACKGROUND: </B>With the emergence of multidrug-resistant infections, healthcare professionals must evaluate the effectiveness of empiric antibiotic treatments.<BR><B>OBJECTIVE: </B>To assess the antibiotic susceptibility patterns of microorganisms causing spontaneous infections in patients with cirrhosis and to evaluate the suitability of empiric antibiotic treatments based on major clinical guidelines.<BR><B>METHODS: </B>This cross-sectional study utilized two datasets from prospective studies of patients with cirrhosis and culture-positive spontaneous bacterial infections in Argentina and Uruguay. We estimated susceptibility to commonly used antibiotics and assessed coverage following European and American recommendations.<BR><B>RESULTS: </B>We analyzed 238 episodes of culture-positive spontaneous infections in 229 patients. When implementing the recommendations for empiric treatment of community-acquired spontaneous infections, ceftazidime would result in 39 % coverage, whereas ceftriaxone would reach 70 %. Cefepime, which is not included in the recommendations, would have provided coverage of 74 %. Using ertapenem for nosocomial infections would have only covered 56 % of these episodes, whereas meropenem or imipenem reached 73 % coverage. Only the combination of meropenem or imipenem plus vancomycin would achieve a coverage surpassing 85 % in healthcare-associated or nosocomial spontaneous bacterial infections.<BR><B>CONCLUSIONS: </B>Our study uncovers inadequate coverage in specific clinical scenarios when adhering to recommendations, underscoring the necessity of guidelines based on local epidemiological data.