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Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage
Journal of Gastroenterology, 08/17/2011
Clinical Article
Kogure H et al. – Fever–based antibiotic therapy for acute cholangitis is safe and effective when resolution of fever is achieved following endoscopic biliary drainage.
Methods- Patients with moderate and severe acute cholangitis were included in this prospective study included.
- 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.
- Primary endpoint was the recurrence of acute cholangitis within 3 days after the withdrawal of antibiotic therapy.
- 18 patients were subjected to the final analysis.
- Causes of cholangitis were bile duct stone (n=17) and bile duct cancer (n=1).
- 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.
