دورية أكاديمية
أعرض في EDS

Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage.

التفاصيل البيبلوغرافية
العنوان: Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage.
المؤلفون: Kogure H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. kogureh-tky@umin.ac.jp, Tsujino T, Yamamoto K, Mizuno S, Yashima Y, Yagioka H, Kawakubo K, Sasaki T, Nakai Y, Hirano K, Sasahira N, Isayama H, Tada M, Kawabe T, Omata M, Harada S, Ota Y, Koike K
المصدر: Journal of gastroenterology [J Gastroenterol] 2011 Dec; Vol. 46 (12), pp. 1411-7. Date of Electronic Publication: 2011 Aug 13.
نوع المنشور: Clinical Trial; Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer International Country of Publication: Japan NLM ID: 9430794 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-5922 (Electronic) Linking ISSN: 09441174 NLM ISO Abbreviation: J Gastroenterol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Tokyo : Springer International, c1994-
مواضيع طبية MeSH: Anti-Bacterial Agents/*therapeutic use , Cholangiopancreatography, Endoscopic Retrograde/*methods , Cholangitis/*surgery , Fever/*drug therapy, Acute Disease ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Cefmetazole/therapeutic use ; Cholangitis/etiology ; Cholangitis/pathology ; Drainage/methods ; Female ; Fever/etiology ; Humans ; Male ; Meropenem ; Middle Aged ; Prospective Studies ; Recurrence ; Severity of Illness Index ; Thienamycins/therapeutic use ; Treatment Outcome
مستخلص: Background: The current management of acute cholangitis consists of antibiotic therapy in combination with biliary drainage. However, the optimal duration of antibiotic therapy after the resolution of clinical symptoms by biliary drainage is unclear. We aimed to evaluate whether discontinuing antibiotic therapy for acute cholangitis immediately after the resolution of clinical symptoms, achieved by endoscopic biliary drainage, was safe and effective.
Methods: This prospective study included patients with moderate and severe acute cholangitis. Cefmetazole sodium and meropenem hydrate were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively. All patients underwent endoscopic biliary drainage within 24 h of diagnosis. When the body temperature of < 37 ° C was maintained for 24 h, administration of antibiotics was stopped. The primary endpoint was the recurrence of acute cholangitis within 3 days after the withdrawal of antibiotic therapy.
Results: Eighteen patients were subjected to the final analysis. The causes of cholangitis were bile duct stone (n = 17) and bile duct cancer (n = 1). The severity of acute cholangitis was moderate in 14 patients and severe in 4. Body temperature of < 37 ° C was achieved in all patients after a median of 2 days (range 1-6) following endoscopic biliary drainage. Antibiotic therapy was administered for a median duration of 3 days (range 2-7). None of the patients developed recurrent cholangitis within 3 days after the withdrawal of antibiotics.
Conclusions: Fever-based antibiotic therapy for acute cholangitis is safe and effective when resolution of fever is achieved following endoscopic biliary drainage.
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المشرفين على المادة: 0 (Anti-Bacterial Agents)
0 (Thienamycins)
3J962UJT8H (Cefmetazole)
FV9J3JU8B1 (Meropenem)
تواريخ الأحداث: Date Created: 20110816 Date Completed: 20120416 Latest Revision: 20211020
رمز التحديث: 20240829
DOI: 10.1007/s00535-011-0451-5
PMID: 21842232
قاعدة البيانات: MEDLINE
الوصف
تدمد:1435-5922
DOI:10.1007/s00535-011-0451-5