Early Intra-Abdominal Bacterial Infections after Orthotopic Liver Transplantation: A Narrative Review for Clinicians
Abstract
:1. Introduction
2. Results
2.1. Epidemiology and Predisposing Factors for IAI
2.2. Surgical Site Infections and Perioperative Prophylaxis
- (a)
- Donor factors such as donor infection;
- (b)
- Host factors such as a profound state of immunosuppression, prolonged intensive care unit stay, antibiotic use in the 3–4 months before surgery, diabetes, high MELD score, hemochromatosis, ascites, obesity, prior hepatobiliary surgery, prior liver or renal transplantation, postoperative acute rejection, or the need for renal replacement therapy (RRT);
- (c)
2.3. MDRO Colonization and Infections
2.4. Reasoned-Empirical Antibiotic Therapy in Early Intra-Abdominal Infections Post OLT and Source Control
2.4.1. Donor Screening
2.4.2. Recipient Screening
2.4.3. Local Epidemiology
2.4.4. Source Control
3. Materials and Methods
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Antibiotic | Dosage |
---|---|
Vancomycin | Loading dose 15–20 mg/kg intravenous (IV), then 30–40 mg/kg IV as continuous infusion |
Linezolid | 600 mg IV every 12 h or 1200 mg IV as continuous infusion |
Tigecyclin | 100 mg IV first dose followed by 50 mg IV every 12 h |
Metronidazole | 500 mg IV every 8 h |
Meropenem | Loading dose 2 g IV and then 1 g every 8 h |
Piperacillin/tazobactam | Loading dose 4.5 g IV and then 18 g as continuous infusion |
Ceftolozane/tazobactam | 1.5–3 g IV every 8 h |
Ceftazidime/avibactam | 2.5 g IV every 8 h * |
Meropenem/vaborbactam | 4 g IV every 8 h |
Imipenem/relebactam | 1.25 g IV every 6 h |
Aztreonam | 2 g IV every 8 h * |
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Taddei, R.; Riccardi, N.; Tiseo, G.; Galfo, V.; Biancofiore, G. Early Intra-Abdominal Bacterial Infections after Orthotopic Liver Transplantation: A Narrative Review for Clinicians. Antibiotics 2023, 12, 1316. https://doi.org/10.3390/antibiotics12081316
Taddei R, Riccardi N, Tiseo G, Galfo V, Biancofiore G. Early Intra-Abdominal Bacterial Infections after Orthotopic Liver Transplantation: A Narrative Review for Clinicians. Antibiotics. 2023; 12(8):1316. https://doi.org/10.3390/antibiotics12081316
Chicago/Turabian StyleTaddei, Riccardo, Niccolò Riccardi, Giusy Tiseo, Valentina Galfo, and Giandomenico Biancofiore. 2023. "Early Intra-Abdominal Bacterial Infections after Orthotopic Liver Transplantation: A Narrative Review for Clinicians" Antibiotics 12, no. 8: 1316. https://doi.org/10.3390/antibiotics12081316
APA StyleTaddei, R., Riccardi, N., Tiseo, G., Galfo, V., & Biancofiore, G. (2023). Early Intra-Abdominal Bacterial Infections after Orthotopic Liver Transplantation: A Narrative Review for Clinicians. Antibiotics, 12(8), 1316. https://doi.org/10.3390/antibiotics12081316