Use of neomycin as the prophylaxis against recurrent cholangitis after Kasai portoenterostomy

Mones, Richard L.; DeFelice, Amy R.; Preud'Homme, Daniel

doi:10.1016/0022-3468(94)90583-5

Cited by 20 publications

(13 citation statements)

References 10 publications

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“…The causative organisms identified in the study are similar to the one reported earlier. 6,10,12 Our study reported 64% of patients developing at least one episode of cholangitis which is in agreement with earlier reports of 59-77%. 7,13 To our knowledge, no study has estimated the cost of a cholangitis episode except one study 14 which quoted the cost to be $US 10 000 for their decision analysis model based on the average 2000 Medicare reimbursement rates at their institution.…”

Section: Discussionsupporting

confidence: 92%

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Cholangitis in children with biliary atresia: Health‐care resource utilisation

Lee

Lim

Quak

et al. 2013

J Paediatrics Child Health

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Section: Discussionsupporting

confidence: 92%

“…The causative organisms identified in the study are similar to the one reported earlier . Our study reported 64% of patients developing at least one episode of cholangitis which is in agreement with earlier reports of 59–77% …”

Section: Discussionsupporting

confidence: 92%

Cholangitis in children with biliary atresia: Health‐care resource utilisation

Lee

Lim

Quak

et al. 2013

J Paediatrics Child Health

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“…Because the current variation of clinical practice among ChiLDREN investigators ranges from discontinuation of prophylactic antibiotics at 2 years post HPE to never stopping antibiotics, there may be an opportunity for more effective prevention of cholangitis episodes. Because the efficacy of antibiotic prophylaxis has not been clearly determined at this age 32, 36, 37 , further prospective, randomized studies are indicated to provide the needed evidence upon which to establish best practices.…”

Section: Discussionmentioning

confidence: 99%

Medical Status of 219 Children with Biliary Atresia Surviving Long-Term with Their Native Livers: Results from a North American Multicenter Consortium

Haber

Magee

et al. 2014

The Journal of Pediatrics

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Objectives To examine the medical status of children with biliary atresia (BA) with their native livers after hepatic portoenterostomy (HPE) surgery. Study design The Childhood Liver Disease Research and Education Network (ChiLDREN) database was utilized to examine subjects with BA living with their native livers 5 or more years after HPE and to describe the prevalence of subjects with BA with an “ideal” outcome, defined as no clinical evidence of chronic liver disease, normal liver biochemical indices (aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase, platelet count, total bilirubin, International Normalized Ratio, and albumin) and normal Health-Related Quality of Life (HRQOL) 5 or more years after HPE. Results Children with BA (n=219; 43% male) with median age 9.7 years were studied. Median age at HPE was 56 (range 7-125) days. Median age- and sex-adjusted height and weight Z-scores at 5 year follow-up were 0.487 (interquartile range [IQR]: -0.27 to 1.02) and 0.00 (IQR: -0.74 to 0.70), respectively. During the 12 preceding months, cholangitis and bone fractures occurred in 17% and 5.5%, respectively. HRQOL was reported normal by 53% of patients. However, only 1.8% met the study definition of “ideal” outcome. Individual tests of liver synthetic function (TB, Alb, and INR) were normal in 75%, 85% and 73% of the study cohort. Conclusion Cholangitis and fractures in long-term survivors underscore the importance of ongoing medical surveillance. Over 98% of this North American cohort of subjects with BA living with native livers 5 or more years after HPE have clinical or biochemical evidence of chronic liver disease.

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“…As fevers are not uncommon in children less than 2 years of age, it can be difficult to be certain of this diagnosis and/or its true prevalence. Typical means of trying to prevent cholangitis include prophylactic antibiotics (for example, trimethoprim sulfamethoxazole) and/or special surgical techniques (intussuscepted antirefluxing valve), although the efficacy of these interventions is unproven 39, 41, 43–45. Cholangitis can be recurrent and/or refractory to medical management, which typically includes a prolonged course of intravenous antibiotics.…”

Section: Recurrent Cholangitismentioning

confidence: 99%