title: Antibiotics May be Safely Discontinued Within One Week of Percutaneous Cholecystostomy.
abstract: For patients with acute cholecystitis managed with percutaneous cholecystostomy (PC), the optimal duration of post-procedural antibiotic therapy is unknown. Our objective was to compare short versus long courses of antibiotics with the hypothesis that patients with persistent signs of systemic inflammation 72 h following PC would receive prolonged antibiotic therapy and that antibiotic duration would not affect outcomes.
  
  
  
  We performed a retrospective cohort analysis of 81 patients who underwent PC for acute cholecystitis at two hospitals during a 41-month period ending November 2014. Patients who received short (≤7 day) courses of post-procedural antibiotics were compared to patients who received long (>7 day) courses. Treatment response to PC was evaluated by systemic inflammatory response syndrome (SIRS) criteria. Logistic and linear regressions were used to evaluate associations between antibiotic duration and outcomes.
  
  
  
  Patients who received short (n = 30) and long courses (n = 51) of antibiotics had similar age, comorbidities, severity of cholecystitis, pre-procedural vital signs, treatment response, and culture results. There were no differences in recurrent cholecystitis (13 vs. 12%), requirement for open/converted to open cholecystectomy (23 vs. 22%), or 1-year mortality (20 vs. 18%). On logistic and linear regressions, antibiotic duration as a continuous variable was not predictive of any salient outcomes.
  
  
  
  Patients who received short and long courses of post-PC antibiotics had similar baseline characteristics and outcomes. Antibiotic duration did not predict recurrent cholecystitis, interval open cholecystectomy, or mortality. These findings suggest that antibiotics may be safely discontinued within one week of uncomplicated PC.
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Loftus
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.|University of Florida Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Brakenridge
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.
authors.forename: Camille G
authors.initials: CG
authors.lastname: Dessaigne
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.|Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, USA.
authors.forename: George A
authors.initials: GA
authors.lastname: Sarosi
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.|Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Zingarelli
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.|University of Florida Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Moore
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.
authors.forename: Janeen R
authors.initials: JR
authors.lastname: Jordan
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.
authors.forename: Chasen A
authors.initials: CA
authors.lastname: Croft
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.
authors.forename: R Stephen
authors.initials: RS
authors.lastname: Smith
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.|University of Florida Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
authors.forename: Phillip A
authors.initials: PA
authors.lastname: Efron
authors.affiliation: Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA. Alicia.Mohr@surgery.ufl.edu.|University of Florida Sepsis and Critical Illness Research Center, Gainesville, FL, USA. Alicia.Mohr@surgery.ufl.edu.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Mohr
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D041881:Cholecystitis, Acute / Q000601:surgery*; D002767:Cholecystostomy / Q000009:adverse effects / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents