Efficacy of Short-Course Antibiotic Therapy for Acute Cholangitis With Positive Blood Cultures: A Retrospective Study

Masuda, Sakue; Imamura, Yoshinori; Ichita, Chikamasa; Jinushi, Ryuhei; Kubota, Jun; Kimura, Karen; Makazu, Makomo; Sato, Ryo; Uojima, Haruki; Koizumi, Kazuya

doi:10.7759/cureus.58883

Cureus

2024

DOI: 10.7759/cureus.58883

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Efficacy of Short-Course Antibiotic Therapy for Acute Cholangitis With Positive Blood Cultures: A Retrospective Study

Sakue Masuda,

Yoshinori Imamura,

Chikamasa Ichita

et al.

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Cited by 1 publication

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Navigating antibiotic therapy in acute cholangitis: Best practices and new insights

Masuda,

Imamura,

Jinushi

et al. 2024

J Hepato Biliary Pancreat

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Globally, antibiotic resistance is linked to increased morbidity, mortality, and healthcare costs, which necessitates further research on optimal antibiotic usage. Acute cholangitis (AC), a common cause of community‐acquired bacteremia, often requires antimicrobial therapy. Therefore, studying the appropriate use of antibiotics for AC is considered crucial for suppressing the emergence of resistant bacteria and reducing adverse antibiotic‐associated events. The Tokyo Guidelines 2018 (TG18) recommend 4–7 days of antibiotics post‐biliary drainage. However, this lacks strong evidence and is based primarily on various evidence and expert opinions. Recent retrospective studies advocate for a shorter 1–3‐day antibiotic course for AC, thereby prompting a need to reassess the treatment duration to balance therapeutic efficacy and minimize resistance and adverse effects. Choosing the appropriate duration and antibiotics based on susceptibility to pathogens causing cholangitis is important. Awareness of local resistance patterns and understanding patients' risks of resistant pathogens are prerequisite for effective treatment. We must explore the applicability of these guidelines in specific scenarios such as severe AC, positive blood cultures, fever, or hilar biliary obstructions due to malignancy. This comprehensive review considers both the duration and type of antibiotics and aims to enhance treatment outcomes while reducing the risk of resistant bacterial infections.

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Navigating antibiotic therapy in acute cholangitis: Best practices and new insights

Masuda,

Imamura,

Jinushi

et al. 2024

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

show abstract

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Efficacy of Short-Course Antibiotic Therapy for Acute Cholangitis With Positive Blood Cultures: A Retrospective Study

Cited by 1 publication

References 41 publications

Navigating antibiotic therapy in acute cholangitis: Best practices and new insights

Navigating antibiotic therapy in acute cholangitis: Best practices and new insights

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