Short-course antimicrobial treatment for acute cholangitis with Gram-negative bacillary bacteremia

Uno, Shunsuke; Hase, Ryota; Kobayashi, Masayoshi; Shiratori, Toshiyasu; Nakaji, So; Hirata, Nobuto; Hosokawa, Naoto

doi:10.1016/j.ijid.2016.12.018

Cited by 29 publications

(49 citation statements)

References 10 publications

(10 reference statements)

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“…The authors assessed clinical cure and bacteriological eradication among the compared treatment groups and found that there was no significant difference in either cure or eradication rates between shortand long-course treatment (78.6% versus 86.8%, respectively; P ϭ NS; and 83.3% versus 89.7%, respectively; P ϭ NS). Finally, 1 study referred to patients treated for bacteremia (25). No significant difference was found in mortality between short-and long-course treatment in that study (0% versus 5.7% for Ͻ14 days and Ն14 days, respectively; P ϭ NS), but relapse was higher among patients who were treated for Ն14 days than those treated for Ͻ14 days (13.3% versus 0%, respectively; P Ͻ 0.05).…”

Section: Figmentioning

confidence: 88%

“…Table 2 presents four studies which used a cutoff other than the 10 days for the classification of treatment as "short" or "long" course. Two of them were double-blind randomized controlled trials (23, 24), 1 was a retrospective cohort study (25), and 1 was a retrospective case-control trial (22). Of those studies, 3 included patients with bacteremia secondary to a single source of infection.…”

Section: Figmentioning

confidence: 99%

“…Of those studies, 3 included patients with bacteremia secondary to a single source of infection. Among those 3 studies, 2 included patients with acute pyelonephritis (23,24), and 1 included patients with acute cholangitis (25).…”

Section: Figmentioning

confidence: 99%

“…No significant difference was found in mortality between short-and long-course treatment in that study (0% versus 5.7% for Ͻ14 days and Ն14 days, respectively; P ϭ NS), but relapse was higher among patients who were treated for Ն14 days than those treated for Ͻ14 days (13.3% versus 0%, respectively; P Ͻ 0.05). The antibiotics administered were not determined in either of these two studies (22,25).…”

Section: Figmentioning

confidence: 99%

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A Systematic Review and Meta-analysis of Antibiotic Treatment Duration for Bacteremia Due to Enterobacteriaceae

Tansarli

Andreatos

Pliakos

et al. 2019

Antimicrob Agents Chemother

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The duration of antibiotic therapy for bacteremia due to Enterobacteriaceae is not well defined. We sought to evaluate the clinical outcomes with shorterversus longer-course treatment. We performed a systematic search of the PubMed and EMBASE databases through May 2018. Studies presenting comparative outcomes between patients receiving antibiotic treatment for Յ10 days ("short-course") and those treated for Ͼ10 days ("long-course") were considered eligible. Four retrospective cohort studies and one randomized controlled trial comprising 2,865 patients met the inclusion criteria. The short-and long-course antibiotic treatments did not differ in 30-day all-cause mortality (1,374 patients; risk ratio [RR] ϭ 0.99; 95% confidence interval [CI], 0.69 to 1.43), 90-day all-cause mortality (1,750 patients; RR ϭ 1.16; 95% CI, 0.81 to 1.66), clinical cure (1,080 patients; RR ϭ 1.02; 95% CI, 0.96 to 1.08), or relapse at 90 days (1,750 patients; RR ϭ 1.08; 95% CI, 0.69 to 1.67). In patients with bacteremia due to Enterobacteriaceae, the short-and long-course antibiotic treatments did not differ significantly in terms of clinical outcomes. Further welldesigned studies are needed before treatment for 10 days or less is adopted in clinical practice.

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Section: Figmentioning

confidence: 88%

Section: Figmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review and Meta-analysis of Antibiotic Treatment Duration for Bacteremia Due to Enterobacteriaceae

Tansarli

Andreatos

Pliakos

et al. 2019

Antimicrob Agents Chemother

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“…Uno et al compared retrospectively the outcomes among patients with bacteremic acute cholangitis due to Gram‐negative bacilli who received antimicrobial therapy over either 14 or 10 days. There were no differences between the two groups in 30‐day mortality and recurrence rate within 3 months.…”

Section: How Should Highly Resistant Causative Organisms Be Managed Imentioning

confidence: 99%

Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

Gomi

Solomkin

Schlossberg

et al. 2018

J Hepato Biliary Pancreat

285

249

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Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. The Tokyo Guidelines 2018 (TG18) provides recommendations for the appropriate use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy provided before the infecting isolates are identified. Antimicrobial agents are listed by classdefinitions and TG18 severity grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored. Prudent antimicrobial usage and early de-escalation or termination of antimicrobial therapy are now important parts of decision-making. What is new in TG18 is that the duration of antimicrobial therapy for both acute cholangitis and cholecystitis is systematically reviewed. Prophylactic antimicrobial usage for elective endoscopic retrograde cholangiopancreatography is no longer recommended and the section was deleted in TG18. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

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Updated comprehensive epidemiology, microbiology, and outcomes among patients with acute cholangitis

Gomi

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

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Background The international practice guidelines for patients with acute cholangitis and cholecystitis were released in 2007 (TG07) and revised in 2013 (TG13). This study investigated updated epidemiology and outcomes among patients with acute cholangitis on a larger scale for the first time. Methods This is an international multi-center retrospective observational study in Japan and Taiwan. All consecutive patients older than 18 years of age and given a clinical diagnosis of acute cholangitis by clinicians between 1 January 2011 and 31 December 2012 were enrolled. Those who met the diagnostic criteria of acute cholangitis by TG13 were statistically analyzed. Results A total of 7,294 patients were enrolled and 6,433 patients met the TG13 diagnostic criteria. The severity distribution was Grade I (37.5%), Grade II (36.2%), and Grade III (26.2%). The 30-day all-cause mortality was 2.4%, 4.7%, and 8.4% in Grade I, II, III severity, respectively (P < 0.001). The incidence of liver abscess and endocarditis as complications of acute cholangitis was 2.0% and 0.26%, respectively. Conclusions This is the first large scale study to investigate patients with acute cholangitis. This study provides the basis to define the best practices to manage patients with acute cholangitis in future studies.

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Short-course antimicrobial treatment for acute cholangitis with Gram-negative bacillary bacteremia

Abstract: The results of this study suggest that acute cholangitis with Gram-negative bacillary bacteremia can be treated safely with a shorter antimicrobial treatment duration of <14 days.

Cited by 29 publications

References 10 publications

A Systematic Review and Meta-analysis of Antibiotic Treatment Duration for Bacteremia Due to Enterobacteriaceae

A Systematic Review and Meta-analysis of Antibiotic Treatment Duration for Bacteremia Due to Enterobacteriaceae

Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

Updated comprehensive epidemiology, microbiology, and outcomes among patients with acute cholangitis

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