Abstract
Objectives The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo Guidelines 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors’ institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice. Methods A single-center retrospective cohort study was conducted. The antimicrobial treatment duration, 30-day mortality rate, and recurrence rate within 3 months were compared between patients treated before May 2013 and after May 2013. Results Ninety-one patients with cholangitis with bacteremia were analyzed. The median antimicrobial treatment duration was 14.5 days in patients treated before May 2013 and 10.0 days after May 2013 (p < 0.001). While the 30-day mortality rate did not differ significantly, the recurrence rate was higher in those treated before May 2013 (5.7% vs. 0.0%, p = 0.17 and 13.3% vs. 0.0%, p = 0.03, respectively). The median treatment duration after May 2013 was 8 days for grade I patients, 10 days for grade II patients, and 11.5 days for grade III patients. Conclusions 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.
| Original language | English |
|---|---|
| Pages (from-to) | 81-85 |
| Number of pages | 5 |
| Journal | International Journal of Infectious Diseases |
| Volume | 55 |
| DOIs | |
| Publication status | Published - 2017 Feb 1 |
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Keywords
- Acute cholangitis
- Antimicrobial stewardship
- Bacteremia
- Drainage
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
Cite this
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.
In: International Journal of Infectious Diseases, Vol. 55, 01.02.2017, p. 81-85.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Short-course antimicrobial treatment for acute cholangitis with Gram-negative bacillary bacteremia
AU - Uno, Shunsuke
AU - Hase, Ryota
AU - Kobayashi, Masayoshi
AU - Shiratori, Toshiyasu
AU - Nakaji, So
AU - Hirata, Nobuto
AU - Hosokawa, Naoto
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objectives The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo Guidelines 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors’ institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice. Methods A single-center retrospective cohort study was conducted. The antimicrobial treatment duration, 30-day mortality rate, and recurrence rate within 3 months were compared between patients treated before May 2013 and after May 2013. Results Ninety-one patients with cholangitis with bacteremia were analyzed. The median antimicrobial treatment duration was 14.5 days in patients treated before May 2013 and 10.0 days after May 2013 (p < 0.001). While the 30-day mortality rate did not differ significantly, the recurrence rate was higher in those treated before May 2013 (5.7% vs. 0.0%, p = 0.17 and 13.3% vs. 0.0%, p = 0.03, respectively). The median treatment duration after May 2013 was 8 days for grade I patients, 10 days for grade II patients, and 11.5 days for grade III patients. Conclusions 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.
AB - Objectives The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo Guidelines 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors’ institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice. Methods A single-center retrospective cohort study was conducted. The antimicrobial treatment duration, 30-day mortality rate, and recurrence rate within 3 months were compared between patients treated before May 2013 and after May 2013. Results Ninety-one patients with cholangitis with bacteremia were analyzed. The median antimicrobial treatment duration was 14.5 days in patients treated before May 2013 and 10.0 days after May 2013 (p < 0.001). While the 30-day mortality rate did not differ significantly, the recurrence rate was higher in those treated before May 2013 (5.7% vs. 0.0%, p = 0.17 and 13.3% vs. 0.0%, p = 0.03, respectively). The median treatment duration after May 2013 was 8 days for grade I patients, 10 days for grade II patients, and 11.5 days for grade III patients. Conclusions 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.
KW - Acute cholangitis
KW - Antimicrobial stewardship
KW - Bacteremia
KW - Drainage
UR - http://www.scopus.com/inward/record.url?scp=85010447539&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010447539&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2016.12.018
DO - 10.1016/j.ijid.2016.12.018
M3 - Article
C2 - 28027992
AN - SCOPUS:85010447539
VL - 55
SP - 81
EP - 85
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -