The WAAW 2023 campaign builds on the previous year’s theme “Preventing antimicrobial resistance together”. Antimicrobial resistance is a growing threat to human and animal health, plants and the environment. Addressing AMR is a global endeavor that requires collaboration across sectors to preserve the effectiveness of antimicrobials. To effectively reduce antimicrobial resistance, all sectors must use antimicrobials prudently and appropriately, take preventive measures to decrease the incidence of infections and follow good practices in disposal of antimicrobial contaminated waste.

This year, EF CLIF joins the World Health Organization’s color campaign to go blue for AMR to raise awareness about the importance of appropriate antimicrobial use and the threat of AMR in the context of chronic liver disease.

The continuous rise in emergence of multidrug resistant organisms (MDROs) – microbes, predominantly bacteria, resistant to one or more antimicrobial agents, including beta-lactam antibiotics – affecting patients with cirrhosis is of global concern.

Patients that present complications of cirrhosis are particularly susceptible to infection by MDROs as a result of bacterial translocation of viable bacteria from the gastrointestinal tract to other tissues and organs. Infections are one of the leading triggers of acute-on-chronic liver failure (ACLF) – a severe form of acutely decompensated cirrhosis characterized by multiorgan system failure and short-term mortality. The growing prevalence of MDROs in patients with acutely decompensated cirrhosis and ACLF is also associated with increased length of in-hospital stay, repeated hospitalizations, the need for invasive procedures, frequent prophylactic antibiotic treatment for preventing nosocomial infection, and depending on the local epidemiology, variations in empirical antimicrobial treatment including practices in narrowing the spectrum of antimicrobial action, de-escalation strategies and cessation [1].