Antibiotic Prophylaxis for Liver Transplantation?
What are the current recommendations regarding antibiotic prophylaxis in liver transplant recipients?

The idea of antibiotic prophylaxis is prevention of immediate infection after the transplant surgery. In the earlier days of liver transplantation, the prophylactic antibiotic course was longer (5 days or more), but in recent years, most investigators support the idea of short prophylaxis (24-48 hours). There are many regimens used, but generally antibiotics with good concentration in the bile are preferable because liver transplant surgery involves biliary anastomosis. It is difficult to recommend 1 regimen over another because centers change their antibiotic prophylaxis based on the pathogens that they encounter in their own medical center. Antibiotics used for prophylaxis include cefotaxime, ampicillin/sulbactam, and ceftriaxone. Many centers performing liver transplantation have seen an increase in the rate of methicillin-resistant Staphylococcus aureus infection, and as a general rule, most investigators discourage the use of vancomycin prophylaxis because of the increase in vancomycin-resistant enterococcal infection. For fungal prophylaxis, most centers still use nystatin or fluconazole.