Three-day antibiotic treatment for acute cholangitis due to choledocholithiasis with successful biliary duct drainage: A single-center retrospective cohort study.

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.