title: Targeting the gut-liver axis in cirrhosis: antibiotics and non-selective β-blockers.
abstract: The gut-liver axis in cirrhosis and portal hypertension is gaining increasing attention as a key pathophysiological mechanism responsible for progression of liver failure and development of complications such as spontaneous infections and hepatocellular carcinoma. Antibiotics and non-selective β-blockers (NSBB) intercept this axis and each drug has proven efficacy in clinical trials. A synergistic effect is a hitherto unproven possibility. There is an increasing body of evidence supporting improved outcome with expanded use of NSBB and antibiotic therapy beyond current indications. This review addresses the issue of pharmacological treatment of cirrhosis and portal hypertension with antibiotics and NSBB. We discuss their mechanism of action and suggest that combining the two treatment modalities could potentially reduce the risk of complications.
authors.affiliation: Department of Medical Gastroenterology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. bjoern.staehr.madsen@rsyd.dk
authors.forename: Bjørn S
authors.initials: BS
authors.lastname: Madsen
authors.forename: Troels
authors.initials: T
authors.lastname: Havelund
authors.forename: Aleksander
authors.initials: A
authors.lastname: Krag
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018988:Bacterial Translocation; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000517:prevention & control; D006530:Hepatorenal Syndrome / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000188:drug therapy*; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy*; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control; D064307:Microbiota; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control
chemical_list: D000319:Adrenergic beta-Antagonists; D000900:Anti-Bacterial Agents