Table 3.

Guidance for empirical antibiotic therapy for non-SBP infections in cirrhosis

Type of infection	Community-acquired infections	Nosocomial infections a
Cellulitis	‘Erysipel’: Penicillin G (i.v.)/V (p.o.) ‘Phlegmone’: Cefazolin (i.v.)/cefalexin (p.o.), flucloxacillin
Urinary tract infections	Uncomplicated: Pivmecillinam, Fosfomycin, ciprofloxacin, or cotrimoxazole
	If sepsis: Aminopenicillin/beta-lactamase inhibitor or cefotaxime or ceftriaxone	If sepsis: Piperacillin/tazobactam or meropenem ± glycopeptideb
Pneumonia	Aminopenicillin/beta-lactamase inhibitor or cefotaxime or ceftriaxone ± macrolide or levofloxacin or moxifloxacin	Piperacillin/tazobactam or cefepime or meropenem ± ciprofloxacin/levofloxacin ± glycopeptide b should be added in case of high MRSA risk c

Dosages of antibiotics have not been formally and specifically investigated or defined in patients with cirrhosis, however, it is advisable to follow standard recommended dosages adopted to renal function

^a Recommended also for health-care associated pneumonia and urinary infections

^b Glycopeptides must be replaced by linezolid or daptomycin in areas with high prevalence of vancomycin-resistant enterococci (VRE)

^c Ventilator-associated pneumonia (VAP), recent antibiotic therapy, nasal MRSA carriage