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  • Shorter IV antibiotic...

Shorter IV antibiotic courses safe after biliary drainage in patients with moderate or severe cholangitis

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-11-10T19:30:47+05:30  |  Updated On 11 Nov 2023 10:40 AM IST
Shorter IV antibiotic courses safe after biliary drainage in patients with moderate or severe cholangitis
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Shorter IV antibiotic courses safe after biliary drainage in patients with moderate or severe cholangitis suggests a new study published in the American Journal of Gastroenterology.

Successful biliary drainage and antibiotics are the mainstays of therapy in management of patients with acute cholangitis. However, the duration of antibiotic therapy after successful biliary drainage has not been prospectively evaluated. We conducted a single-center, randomized, noninferiority trial to compare short duration of antibiotic therapy with conventional duration of antibiotic therapy in patients with moderate or severe cholangitis.

METHODS:

Consecutive patients were screened for the inclusion criteria and randomized into either conventional duration (CD) group (8 days) or short duration (SD) group (4 days) of antibiotic therapy. The primary outcome was clinical cure (absence of recurrence of cholangitis at day 30 and >50% reduction of bilirubin at day 15). Secondary outcomes were total days of antibiotic therapy and hospitalization within 30 days, antibiotic-related adverse events, and all-cause mortality at day 30.

RESULTS:

The study included 120 patients (the mean age was 55.85 ± 13.52 years, and 50% were male patients). Of them, 51.7% patients had malignant etiology and 76.7% patients had moderate cholangitis. Clinical cure was seen in 79.66% (95% confidence interval, 67.58%–88.12%) patients in the CD group and 77.97% (95% confidence interval, 65.74%–86.78%) patients in the SD group (P = 0.822). On multivariate analysis, malignant etiology and hypotension at presentation were associated with lower clinical cure. Total duration of antibiotics required postintervention was lower in the SD group (8.58 ± 1.92 and 4.75 ± 2.32 days; P < 0.001). Duration of hospitalization and mortality were similar in both the groups.

Short duration of antibiotics is noninferior to conventional duration in patients with moderate-to-severe cholangitis in terms of clinical cure, recurrence of cholangitis, and overall mortality.

Reference:

Srinu, Deshidi MD1; Shah, Jimil MD1; Jena, Anuraag MD1; Jearth, Vaneet MD1; Singh, Anupam K. MD1; Mandavdhare, Harshal S. MD1; Sharma, Vishal MD1; Irrinki, Santosh MS2; Sakaray, Yashwant Raj MS2; Gupta, Rajesh Mch3; Gautam, Vikas MD4; Rana, Surinder MD1; Dutta, Usha MD1. Conventional vs Short Duration of Antibiotics in Patients With Moderate or Severe Cholangitis: Noninferiority Randomized Trial. The American Journal of Gastroenterology ():10.14309/ajg.0000000000002499, October 9, 2023. | DOI: 10.14309/ajg.0000000000002499

Keywords:

shorter, IV, antibiotic, courses, safe, after, biliary, drainage, patients, moderate, severe, cholangitis,American journal of gastroenterology

shorterIVantibioticcoursessafeafterbiliarydrainagepatientsmoderateseverecholangitisAmerican journal of gastroenterology
Source : American journal of gastroenterology
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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