Antimicrobial Resistance in Cirrhosis

Purpose of Review: Antimicrobial resistance (AMR) is recognized as a critical global public health threat. This paper provides a comprehensive overview of AMR in the context of cirrhosis, a condition associated with increased susceptibility to bacterial infections. Patients with cirrhosis face elevated risks of both community-acquired and nosocomial infections, contributing to significant morbidity and mortality. The gut microbiome and leaky gut play a pivotal role in cirrhosis-associated immune dysregulation, creating an environment conducive to infections. Geographical variations in AMR prevalence underscore the importance of tailored treatment strategies. This review highlights the need for judicious antimicrobial stewardship and the implementation of empiric antibiotic guidelines. Recent Findings: Emerging technologies, such as MALDI-TOF mass spectrometry and the Accelerate Pheno system, show promise in expediting antimicrobial susceptibility testing. Fecal microbiota transplantation (FMT), probiotics, and phage therapy represent innovative approaches to restoring microbial balance and combating AMR. Collaborative efforts at various levels, including governments, non-governmental organizations, and healthcare facilities, are essential in the fight against AMR. Summary: This comprehensive overview provides valuable insights into the multifaceted challenges of AMR in cirrhosis and underscores the urgency of a concerted global effort to address this pressing public health issue. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.