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International Journal of Hepatology
Volume 2011, Article ID 784540, 7 pages
Review Article

Prevention and Management of Bacterial Infections in Cirrhosis

Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India

Received 20 April 2011; Accepted 3 June 2011

Academic Editor: Deepak Amarapurkar

Copyright © 2011 Sunil K. Taneja and Radha K. Dhiman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Patients with cirrhosis of liver are at risk of developing serious bacterial infections due to altered immune defenses. Despite the widespread use of broad spectrum antibiotics, bacterial infection is responsible for up to a quarter of the deaths of patients with liver disease. Cirrhotic patients with gastrointestinal bleed have a considerably higher incidence of bacterial infections particularly spontaneous bacterial peritonitis. High index of suspicion is required to identify infections at an early stage in the absence of classical signs and symptoms. Energetic use of antibacterial treatment and supportive care has decreased the morbidity and mortality over the years; however, use of antibiotics has to be judicious, as their indiscriminate use can lead to antibiotic resistance with potentially disastrous consequences. Preventive strategies are still in evolution and involve use of antibiotic prophylaxis in patients with gastrointestinal bleeding and spontaneous bacterial infections and selective decontamination of the gut and oropharynx.