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

Autor:	Masuda S; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN., Imamura Y; Division of Medical Oncology/Hematology, University of Fukui Hospital, Fukui, JPN., Ichita C; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN., Jinushi R; Department of Gastroenterology, Saitama Medical University international Medical Center, Hidaka, JPN., Kubota J; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN., Kimura K; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN., Makazu M; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN., Sato R; Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, JPN., Uojima H; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN., Koizumi K; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Apr 24; Vol. 16 (4), pp. e58883. Date of Electronic Publication: 2024 Apr 24 (Print Publication: 2024).
DOI:	10.7759/cureus.58883
Abstrakt:	Background: Short-term treatment of acute cholangitis is sufficient for cure compared with the standard treatment duration. Whether this short-course antimicrobial therapy is effective in patients with acute cholangitis with positive blood cultures has not been fully investigated. This study assessed whether patients with acute cholangitis could achieve successful outcomes with a three-day or shorter antimicrobial treatment period, even with a positive blood culture. Methods: This single-center retrospective study involved patients with acute cholangitis, defined according to the Tokyo Guidelines 2018 for any cause, who underwent successful biliary drainage and completed a seven-day or shorter antimicrobial treatment. Patients were categorized into six groups based on the duration of antibiotic use (short or standard) after endoscopic retrograde cholangiopancreatography and blood culture findings (positive, negative, or no collection). The primary outcome was the clinical cure rate, defined as no initial presenting symptoms by day 14 after biliary drainage and no recurrence or death by day 30. Secondary outcomes included a three-month recurrence rate and length of hospital stay. Results: In total, 389 cases were selected, and 27 patients (6.9%) undergoing short-course therapy tested positive for blood culture. The clinical cure rate (n=25, 92.6%) in this group was comparable to that in the other groups. For the three-month recurrence rate (n=1, 3.7%) and median hospital stay (six days), this group's outcomes were either better or similar to those of the other groups. Conclusions: For cases of successful drainage in acute cholangitis, even with positive blood cultures, short-term antibiotic therapy may be appropriate. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Masuda et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu