Comparison of short-course antibiotic therapy of 6 or less days with a longer treatment in patients with cholangitis after liver transplantation.

Anti-Bacterial Agents / therapeutic use Cholangitis / drug therapy Cholestasis / etiology Humans Liver Transplantation / adverse effects Postoperative Complications / etiology Retrospective Studies
biliary stricture liver transplantation multidrug resistance recurrent cholangitis short-course antibiotic therapy

Journal

Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688

Informations de publication

Date de publication:
Aug 2022
Historique:
revised: 25 04 2022
received: 04 02 2022
accepted: 12 05 2022
pubmed: 23 5 2022
medline: 13 8 2022
entrez: 22 5 2022
Statut: ppublish

Résumé

Stenosis of the biliary anastomosis predisposes liver graft recipients to bacterial cholangitis. Antibiotic therapy (AT) is performed according to individual clinical judgment, but duration of AT remains unclear. All liver graft recipients with acute cholangitis according to the Tokyo criteria grade 1 and 2 after endoscopic retrograde cholangiography (ERC) were included. Outcome of patients treated with short AT (<7 days) was compared to long AT (>6 days). Recurrent cholangitis (RC) within 28 days was the primary end point. In total, 30 patients were included with a median of 313 (range 34-9849) days after liver transplantation until first proven cholangitis. Among 62 cases in total, 51/62 (82%) were graded as Tokyo-1 and 11/62 (18%) as Tokyo-2. Overall median duration of AT was 6 days (1-14) with 36 cases (58%) receiving short AT and 26 (42%) receiving long AT. RC was observed in 10 (16%) cases, without significant difference in occurrence of RC in short versus long AT cases. CRP and bilirubin were significantly higher in patients with long AT, while low serum albumin and low platelets were associated with risk of RC. A shorter antibiotic course than 7 days shows good results in selected, ERC-treated patients for post-transplantation biliary strictures.

Identifiants

DOI: 10.1111/tid.13868 PMID: 35598281
pubmed: 35598281
doi: 10.1111/tid.13868
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13868

Informations de copyright

© 2022 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC.

Références

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Auteurs

Philip G Ferstl (PG)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.
ORCID: 0000-0002-0836-6643

Alexander Queck (A)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Katharina Bremer (K)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Natalie Filmann (N)

Institute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt am Main, Germany.

Nina Weiler (N)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Martin-W Welker (MW)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Oliver Waidmann (O)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Mate Knabe (M)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Wolf O Bechstein (WO)

Department for General and Hepatobiliary Surgery, University Hospital, Goethe University, Frankfurt am Main, Germany.

Michael Hogardt (M)

Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, University Center of Competence for Infection Control of the State of Hesse, Frankfurt Main, Germany.

Volkhard A J Kempf (VAJ)

Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, University Center of Competence for Infection Control of the State of Hesse, Frankfurt Main, Germany.

Stefan Zeuzem (S)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Jonel Trebicka (J)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Mireen Friedrich-Rust (M)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

Dirk Walter (D)

Department for Internal Medicine I/Gastroenterology and Hepatology, University Hospital, Goethe University, Frankfurt am Main, Germany.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Comparison of short-course antibiotic therapy...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladie des voies biliaires › Maladies des canaux biliaires › Angiocholite › Comparison of short-course antibiotic therapy...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladie des voies biliaires › Maladies des canaux biliaires › Cholestase › Comparison of short-course antibiotic therapy...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Comparison of short-course antibiotic therapy...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation de tissu › Transplantation hépatique › Comparison of short-course antibiotic therapy...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Comparison of short-course antibiotic therapy...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Comparison of short-course antibiotic therapy...