Antimicrobial therapy for acute cholangitis: Tokyo Guidelines.
Antimicrobial agents should be administered to all patients with suspected acute cholangitis as a priority as soon as possible. Bile cultures should be performed at the earliest opportunity. The important factors which should be considered in selecting antimicrobial therapy include the agent's activity against potentially infecting bacteria, the severity of the cholangitis, the presence or absence of renal and hepatic diseases, the patient's recent history of antimicrobial therapy, and any recent culture results, if available. Biliary penetration of the microbial agents should also be considered in the selection of antimicrobials, but activity against the infecting isolates is of greatest importance. If the causative organisms are identified, empirically chosen antimicrobial drugs should be replaced by narrower-spectrum antimicrobial agents, the most appropriate for the species and the site of the infection.
Tanaka
Atsushi
A
Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
Takada
Tadahiro
T
Kawarada
Yoshifumi
Y
Nimura
Yuji
Y
Yoshida
Masahiro
M
Miura
Fumihiko
F
Hirota
Masahiko
M
Wada
Keita
K
Mayumi
Toshihiko
T
Gomi
Harumi
H
Solomkin
Joseph S
JS
Strasberg
Steven M
SM
Pitt
Henry A
HA
Belghiti
Jacques
J
de Santibanes
Eduardo
E
Padbury
Robert
R
Chen
Miin-Fu
MF
Belli
Giulio
G
Ker
Chen-Guo
CG
Hilvano
Serafin C
SC
Fan
Sheung-Tat
ST
Liau
Kui-Hin
KH
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001646:Bile / Q000382:microbiology; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use; D002761:Cholangitis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone