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Published on: June 26, 2020
[Severe alcoholic hepatitis-associated infection]
1Department of Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, China.
Abstract:
Patients with severe alcoholic hepatitis is sensitive to concurrent infection and impact glucocorticoid response and disease prognosis. Glucocorticoids can increase the incidence and of serious infections and fungal infections. Among them, Gram-negative bacterial infections are the major one, and invasive fungal infections are not uncommon. Early diagnosis and empiric anti-infective therapy are important means for severe alcoholic hepatitis with concurrent infection. Anti-infective strategies covering multiple drug-resistant bacteria should be timely formulated after determining the high risk of multiple drug-resistant bacterial infections.
Insights
Severe alcoholic hepatitis patients face high infection risks, which impact treatment outcomes. Early diagnosis and broad-spectrum antibiotics are crucial for managing these serious bacterial and fungal infections, especially with rising antimicrobial resistance.
Area of Science:
- Hepatology
- Infectious Diseases
- Pharmacology
Background:
- Severe alcoholic hepatitis (SAH) patients are highly susceptible to concurrent infections.
- Infections significantly impact glucocorticoid response and overall disease prognosis in SAH.
- Glucocorticoids, while used in SAH treatment, can increase the risk of serious bacterial and fungal infections.
Purpose of the Study:
- To highlight the critical role of concurrent infections in SAH.
- To emphasize the impact of infections on glucocorticoid efficacy and patient outcomes.
- To underscore the importance of early diagnosis and prompt anti-infective therapy in SAH.
Main Methods:
- Review of literature on infections in severe alcoholic hepatitis.
- Analysis of the impact of infections on treatment response and prognosis.
- Discussion of current anti-infective strategies for SAH.
Main Results:
- Gram-negative bacterial infections are the predominant type in SAH.
- Invasive fungal infections are a significant concern in this patient population.
- Concurrent infections negatively affect glucocorticoid response and worsen prognosis.
Conclusions:
- Early diagnosis and empiric anti-infective therapy are vital for managing infections in SAH.
- Anti-infective strategies must consider coverage for multidrug-resistant bacteria, especially in high-risk patients.
- Prompt and appropriate management of infections is essential for improving outcomes in severe alcoholic hepatitis.
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