title: Role of ciprofloxacin in patients with cholestasis after endoscopic retrograde cholangiopancreatography.
abstract: OBJECTIVE
  To determine the role of ciprofloxacin in reducing cholangitis in cholestatic patients with adequate biliary drainage after endoscopic retrograde cholangiopancreatography (ERCP).
  
  
  METHODS
  A randomized, controlled trial was performed in 48 cholestatic patients at Rajavithi Hospital (Tertiary Referral Center for ERCP: 600 cases per year). All the 48 patients received 200 mg ciprofloxacin intravenous injection for 30 min before starting any procedures, and then were randomly divided in two groups. Twenty-two patients in study group continually received ciprofloxacin until 48 h after ERCP. Causes of biliary obstruction, bacteriology of bile and blood (in cholangitis) and clinical cholangitis were recorded.
  
  
  RESULTS
  Forty-eight patients were enrolled and divided into continuous ciprofloxacin treatment group (n = 22) and discontinuous ciprofloxacin treatment group (n = 26). During ERCP, stones were found in 22 patients, malignant diseases in 24 patients and other pathologic lesions in 5 patients. One (4.5%) of the 22 patients who received ciprofloxacin and 2 (6.3%) of the 26 patients who discontinued ciprofloxacin after ERCP developed cholangitis (relative risk = 0.71; 95% CI = 0.14-3.65; P = 0.88). Bacterobilia was found in 27 (56.3%) out of 48 patients. E. coli and Streptococcus viridans were the most common organisms.
  
  
  CONCLUSIONS
  Continual use of ciprofloxacin in patients with cholestasis after adequate biliary drainage procedures plays no role in reducing cholangitis.
authors.affiliation: Department of Surgery, Rajavithi Hospital, Rajavithi Rd, Rajathevi, Bangkok 10400, Thailand. Thawee1958@hotmail.com
authors.forename: Thawee
authors.initials: T
authors.lastname: Ratanachu-ek
authors.forename: Pitchaya
authors.initials: P
authors.lastname: Prajanphanit
authors.forename: Kawin
authors.initials: K
authors.lastname: Leelawat
authors.forename: Suchart
authors.initials: S
authors.lastname: Chantawibul
authors.forename: Sukij
authors.initials: S
authors.lastname: Panpimanmas
authors.forename: Somboon
authors.initials: S
authors.lastname: Subwongcharoen
authors.forename: Jerasak
authors.initials: J
authors.lastname: Wannaprasert
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D001646:Bile / Q000382:microbiology; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002761:Cholangitis / Q000517:prevention & control*; D002779:Cholestasis / Q000175:diagnosis*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin