Management of Sepsis Secondary toPneumonia with Empirical Antibiotics in Cirrhotic Patients

Abstract

Cirrhosis is a gradually developing, chronic disease of the liver which always involves the organ as a whole. It is the irreversible consequence and final stage of various chronic liver diseases of different etiology or the result of long-term exposure to various noxae. The extent of the morphological changes depends on the cause and stage of cirrhosis (Kuntz and Kuntz, 2006 (A)). Sepsis, defined by consensus conference as "the systemic inflammatoryresponse syndrome that occurs during infection". The statistics related to the incidence of sepsis are striking. The reported rates of severe sepsis average around 10 cases per 100 intensive care unit admissions(Neviere, 2012).

A number of risk factors exist for the development and progression of sepsis, including advanced age, compromised immune system response, chronic illness, broad-spectrum antibiotic use, and exposure to infection risk associated with surgical and invasive procedures(Hotchkiss and Karl, 2003).

Bacterial infections are much more common in patientswith cirrhosis than in the general population. Infection ismore frequent in patients with decompensated thanin those with compensated cirrhosis(Wasmuth et al., 2005).