In vitro activity of moxifloxacin and piperacillin/sulbactam against pathogens of acute cholangitis.
OBJECTIVE
To analyze the in vitro activity of moxifloxacin and piperacillin/sulbactam against pathogens isolated from patients with acute cholangitis.


METHODS
In this prospective study a total of 65 patients with acute cholangitis due to biliary stone obstruction (n = 7), benign biliary stricture (n = 16), and malignant biliary stricture (n = 42) were investigated with regard to spectrum of bacterial infection and antibiotic resistance. Pathogens were isolated from bile cultures in all study patients. In 22 febrile patients, blood cultures were also obtained. In vitro activity of moxifloxacin and piperacillin/sulbactam was determined by agar diffusion.


RESULTS
Thirty-one out of 65 patients had positive bile and/or blood cultures. In 31 patients, 63 isolates with 17 different species were identified. The predominant strains were Enterococcus species (26/63), E.coli (13/63) and Klebsiella species (8/63). A comparable in vitro activity of moxifloxacin and piperacillin/sulbactam was observed for E.coli and Klebsiella species. In contrast, Enterococcus species had higher resistances towards moxifloxacin. Overall bacteria showed antibiotic resistances in vitro of 34.9% for piperacillin/sulbactam and 36.5% for moxifloxacin.


CONCLUSIONS
Enterococcus species, E.coli and Klebsiella species were the most common bacteria isolated from bile and/or blood from patients with acute cholangitis. Overall, a mixed infection with several species was observed, and bacteria showed a comparable in vitro activity for piperacillin/sulbactam and moxifloxacin.
Department of Gastroenterology, Klinikum Rechts der Isar, Technical University Munich, Munich 81675, Germany.
Andreas
A
Weber
Wolfgang
W
Huber
Klaus
K
Kamereck
Philipp
P
Winkle
Petra
P
Voland
Hans
H
Weidenbach
Roland M
RM
Schmid
Christian
C
Prinz
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001372:Aza Compounds / Q000494:pharmacology*; D001646:Bile / Q000382:microbiology; D002761:Cholangitis / Q000188:drug therapy / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D010878:Piperacillin / Q000494:pharmacology*; D011446:Prospective Studies; D011804:Quinolines / Q000494:pharmacology*; D013407:Sulbactam / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D013407:Sulbactam; D000077266:Moxifloxacin; D010878:Piperacillin