Short Versus Long Antibiotic Therapy and Risk of Recurrence of Acute Cholangitis Due to Malignant Biliary Strictures.

antibiotic duration cancer-associated cholangitis metal stent multidrug resistance recurring cholangitis

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
24 Oct 2023
Historique:
received: 04 09 2023
revised: 23 09 2023
accepted: 28 09 2023
medline: 14 11 2023
pubmed: 14 11 2023
entrez: 14 11 2023
Statut: epublish

Résumé

Malignancies can cause severe stenosis of the biliary tract and therefore predispose a patient to bacterial cholangitis. Upon endoscopic drainage, antibiotic therapy (AT) is performed according to individual clinical judgement, as the optimal duration of AT is unclear to date, especially in the case of multidrug-resistant organisms (MDROs). In a case-based retrospective study, patients with malignant biliary strictures and acute cholangitis were included upon endoscopic retrograde cholangiography (ERC). The outcome of cases treated with short AT (≤6 days) was compared to that of long AT (≥7 days). Recurrent cholangitis (RC) before scheduled stent exchange was the primary end point. In total, 124 patients were included, with 183 cases of proven cholangitis in total. The overall median duration of AT was 7 days (range 1-20), with 74 cases (40%) receiving short AT and 109 (60%) receiving long AT. Short AT was not an independent risk factor for RC (HR = 0.66,

Identifiants

pubmed: 37959182
pii: jcm12216716
doi: 10.3390/jcm12216716
pmc: PMC10648096
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

PLoS One. 2019 Jan 23;14(1):e0210991
pubmed: 30673776
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):31-40
pubmed: 28941329
PLoS One. 2020 Nov 25;15(11):e0242544
pubmed: 33237921
Microorganisms. 2019 Aug 21;7(9):
pubmed: 31438593
Dig Dis Sci. 2021 Dec;66(12):4128-4139
pubmed: 33462749
Gastrointest Endosc. 2002 Apr;55(4):518-22
pubmed: 11923764
Clin Microbiol Infect. 2012 Mar;18(3):268-81
pubmed: 21793988
Liver Int. 2017 Oct;37(10):1488-1496
pubmed: 28374901
Transpl Infect Dis. 2022 Aug;24(4):e13868
pubmed: 35598281
Eur J Clin Microbiol Infect Dis. 2022 Jan;41(1):143-146
pubmed: 34415466
Euro Surveill. 2016;21(2):
pubmed: 26794850
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):3-16
pubmed: 29090866
Endoscopy. 2018 Sep;50(9):910-930
pubmed: 30086596
J Cancer Res Clin Oncol. 2022 Jun;148(6):1465-1472
pubmed: 34283288
Nat Rev Gastroenterol Hepatol. 2016 Jan;13(1):28-37
pubmed: 26526122

Auteurs

Philip G Ferstl (PG)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Katharina Bremer (K)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Natalie Filmann (N)

Goethe University Frankfurt, Institute of Biostatistics and Mathematical Modeling, 60590 Frankfurt, Germany.

Volkhard A J Kempf (VAJ)

Goethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection Control, University Center of Competence for Infection Control of the State of Hesse, 60590 Frankfurt, Germany.

Michael Hogardt (M)

Goethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection Control, University Center of Competence for Infection Control of the State of Hesse, 60590 Frankfurt, Germany.

Olivier Ballo (O)

Goethe University Frankfurt, University Hospital, Medical Clinic 2, 60590 Frankfurt, Germany.

Fabian Finkelmeier (F)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Jonel Trebicka (J)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.
Department of Internal Medicine B, University of Münster, 48149 Münster, Germany.
European Foundation for the Study of Chronic Liver Failure, 08021 Barcelona, Spain.

Stefan Zeuzem (S)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Jörg Bojunga (J)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Mireen Friedrich-Rust (M)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Dirk Walter (D)

Goethe University Frankfurt, University Hospital, Medical Clinic 1, 60590 Frankfurt, Germany.

Classifications MeSH