title: Antimicrobial therapy for acute cholangitis: Tokyo Guidelines.
abstract: 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.
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawarada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nimura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Keita
authors.initials: K
authors.lastname: Wada
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Harumi
authors.initials: H
authors.lastname: Gomi
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Solomkin
authors.forename: Steven M
authors.initials: SM
authors.lastname: Strasberg
authors.forename: Henry A
authors.initials: HA
authors.lastname: Pitt
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Santibanes
authors.forename: Robert
authors.initials: R
authors.lastname: Padbury
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
authors.forename: Giulio
authors.initials: G
authors.lastname: Belli
authors.forename: Chen-Guo
authors.initials: CG
authors.lastname: Ker
authors.forename: Serafin C
authors.initials: SC
authors.lastname: Hilvano
authors.forename: Sheung-Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Kui-Hin
authors.initials: KH
authors.lastname: Liau
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone