Advances in Therapy

, Volume 30, Issue 7, pp 659–670

Targeting the Gut–Liver Axis in Cirrhosis: Antibiotics and Non-Selective β-Blockers


    • Department of Medical GastroenterologyOdense University Hospital
  • Troels Havelund
    • Department of Medical GastroenterologyOdense University Hospital
  • Aleksander Krag
    • Department of Medical GastroenterologyOdense University Hospital

DOI: 10.1007/s12325-013-0044-1

Cite this article as:
Madsen, B.S., Havelund, T. & Krag, A. Adv Ther (2013) 30: 659. doi:10.1007/s12325-013-0044-1


The gut–liver axis in cirrhosis and portal hypertension is gaining increasing attention as a key pathophysiological mechanism responsible for progression of liver failure and development of complications such as spontaneous infections and hepatocellular carcinoma. Antibiotics and non-selective β-blockers (NSBB) intercept this axis and each drug has proven efficacy in clinical trials. A synergistic effect is a hitherto unproven possibility. There is an increasing body of evidence supporting improved outcome with expanded use of NSBB and antibiotic therapy beyond current indications. This review addresses the issue of pharmacological treatment of cirrhosis and portal hypertension with antibiotics and NSBB. We discuss their mechanism of action and suggest that combining the two treatment modalities could potentially reduce the risk of complications.


Adrenergic beta-antagonistAnti-bacterial agentsBacterial translocationCirrhosisGut–liver axisMicrobiotaPortal hypertension

Copyright information

© Springer Healthcare 2013