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J Hepatobiliary Pancreat Surg. 2007;14(1):59-67. Epub 2007 Jan 30.

Antimicrobial therapy for acute cholangitis: Tokyo Guidelines.

Author information

1
Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.

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.

PMID:
17252298
PMCID:
PMC2784514
DOI:
10.1007/s00534-006-1157-6
[Indexed for MEDLINE]
Free PMC Article

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