TY - JOUR T1 - Non-selective beta-blocker use in cirrhosis: the additional benefit in preventing secondary infections JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 86 LP - 88 DO - 10.1136/flgastro-2021-101818 VL - 13 IS - 1 AU - Rooshi Nathwani AU - David Kockerling AU - Benjamin H Mullish AU - Alexander Cole AU - Maud Lemoine AU - Charalambos Gustav Antoniades AU - Mark R Thursz AU - Ameet Dhar Y1 - 2022/01/01 UR - http://fg.bmj.com/content/13/1/86.abstract N2 - We read with interest the work by Jachs et al, reporting the benefits of non-selective beta blockers (NSBBs) in reducing systemic inflammation in individuals with cirrhosis, with an associated reduced rate of acute decompensation and mortality.1 Systemic inflammation is a hallmark of cirrhosis-associated immune dysfunction, representing pathological translocation of bacteria and/or bacterial products from the gut.2 Cirrhotics have an increased risk of developing infection,3 with substantially increased mortality when such infections occur.4 5 Secondary infections significantly contribute to this, and predict 30-day mortality independently of disease severity.6 7 Extending on the work of Jachs et al, we here report a beneficial impact of NSBB on clinical and microbiological outcomes of decompensated cirrhotics in both a specialist outpatient setting and inpatients. We also report the novel finding of a reduction in circulating bacterial DNA (bDNA) levels in a subset of cirrhotics with primary infections on NSBB.We retrospectively analysed 138 patients with Child-Pugh grade B/C cirrhosis attending a specialist cirrhosis outpatient clinic at St Mary’s Hospital, London, over a 2-year period. Patients were included at the point of clinic attendance, with records … ER -