title: Antibiotic stewardship and empirical antibiotic treatment: How can they get along?
abstract: The aim of this review is to focus on the recent knowledge on antibiotic stewardship and empiric antibiotic treatment in cirrhotic patients. The application of antimicrobial stewardship (AMS) rules appears to be the most appropriate strategy to globally manage cirrhotic patients with infectious complications: indeed they represent a unique way to provide both early diagnosis and appropriate therapy in order to avoid not only antibiotic over-prescription but, more importantly, selection and spread of antimicrobial resistance. Moreover, cirrhotic patients must be considered "frail" and susceptible to healthcare associated infections: applying AMS policies would assure a cost reduction and thus contribute to the improvement of public health strategies.
authors.affiliation: Department of Infectious Diseases - Fondazione IRCCS Policlinico San Matteo,Pavia.
authors.forename: Valentina
authors.initials: V
authors.lastname: Zuccaro
authors.affiliation: Department of Infectious Diseases - Fondazione IRCCS Policlinico San Matteo,Pavia.
authors.forename: Paola
authors.initials: P
authors.lastname: Columpsi
authors.affiliation: Department of Infectious Diseases - Fondazione IRCCS Policlinico San Matteo,Pavia.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sacchi
authors.affiliation: Gastroenterology Hepatology and Transplant Unit, Departement of Specialty and Transplant Medicine Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Lucà
authors.affiliation: Gastroenterology Hepatology and Transplant Unit, Departement of Specialty and Transplant Medicine Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.affiliation: Department of Infectious Diseases - Fondazione IRCCS Policlinico San Matteo,Pavia; Department of Diagnostic, Paediatric, Clinical and Surgical Science University of Pavia, Pavia, Italy. Electronic address: raffaele.bruno@unipv.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000073602:Antimicrobial Stewardship; D001424:Bacterial Infections / Q000145:classification* / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic stewardship; Cirrhosis; Empirical antibiotic treatment