Department of Gastroenterology, Kenwakai Otemachi Hospital, Kitakyusyu, Japan.
Internal medicine, Kenwakai Otemachi Hospital, Kitakyusyu, Japan.
Int J Infect Dis. 2020 Jul;96:343-347. doi: 10.1016/j.ijid.2020.04.074. Epub 2020 May 4.
Given that the optimal antibiotic treatment duration for acute cholangitis with successful biliary drainage remains unknown, this study aimed to validate whether antibiotic treatment duration could be reduced to ≤3 days among patients presenting the same.
This retrospective study included patients who presented with mild to moderate acute cholangitis due to choledocholithiasis who had undergone successful biliary drainage through endoscopic retrograde cholangiopancreatography (ERCP). After that, 30-day mortality rates and 3-month recurrence rates following short-course antibiotic treatment (SCT, ≤3 days) and long-course antibiotic treatment (LCT, ≥4 days) were compared.
A total of 96 patients were analyzed, among whom 22 (22.9%) received SCT, and 74 (77.1%) received LCT. The SCT and LCT groups had a median antibiotic treatment duration of 1.5 (range 1-3) and seven (range 4-17) days, respectively. Moreover, the SCT and LCT groups exhibited no significant differences in cholangitis grades, 30-day mortality rates (0%, 0/22 and 2.7%, 2/74, respectively), 3-month recurrence rates, length of hospitalization, and acute bacteremic cholangitis rates.
This study suggests that antibiotic treatment for ≤3 days may be adequate for patients with mild to moderate acute cholangitis due to choledocholithiasis who had undergone successful biliary drainage.
鉴于成功胆道引流后急性胆管炎的最佳抗生素治疗持续时间仍不清楚，本研究旨在验证对于同样表现的患者，抗生素治疗时间是否可以缩短至≤3 天。
本回顾性研究纳入了因胆总管结石而行内镜逆行胰胆管造影（ERCP）成功胆道引流的轻中度急性胆管炎患者。然后比较了短疗程抗生素治疗（SCT，≤3 天）和长疗程抗生素治疗（LCT，≥4 天）后 30 天死亡率和 3 个月复发率。
共分析了 96 例患者，其中 22 例（22.9%）接受 SCT，74 例（77.1%）接受 LCT。SCT 和 LCT 组的抗生素治疗持续时间中位数分别为 1.5（范围 1-3）天和 7（范围 4-17）天。此外，SCT 和 LCT 组的胆管炎分级、30 天死亡率（0%，0/22 和 2.7%，2/74）、3 个月复发率、住院时间和急性菌血症性胆管炎发生率均无显著差异。
本研究表明，对于成功胆道引流的胆总管结石所致轻中度急性胆管炎患者，抗生素治疗≤3 天可能是足够的。
