ArticleBMC gastroenterology2020
Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis.
Article in BMC gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Microbiology and antimicrobial resistance in biliary tract infections including acute and post-ERCP cholangitis: a systematic review and meta-analysis.Annals of Saudi medicinePooled it
- Article
- Carbapenem resistance and hypervirulence iniScience · 2026Review
- Microbiological Characteristics of Pathogens Isolated From Blood Cultures of Patients With Acute Cholangitis: Insights From Patients With Biliary-Enteric Anastomosis.Journal of hepato-biliary-pancreatic sciences · 2025Article
- Article
- Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study.Antibiotics (Basel, Switzerland) · 2025Article
- Urgent Endoscopic Biliary Procedures: "Run Like the Wind"?Journal of clinical medicine · 2025Review
- Shifting of Distribution and Changing of Antibiotic Resistance in Gram-Positive Bacteria from Bile of Patients with Acute Cholangitis.Infection and drug resistance · 2025Article
- Navigating antibiotic therapy in acute cholangitis: Best practices and new insights.Journal of hepato-biliary-pancreatic sciences · 2025Review
- Epidemiology of biliary tract-associated bloodstream infections and adequacy of empiric therapy: an Australian population-based study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Acute cholangitis: a state-of-the-art review.Annals of medicine and surgery (2012) · 2024Review
- Bile Culture May Guide Antibiotic Stewardship in Acute Bacterial Cholangitis.Digestive diseases and sciences · 2024Article
- Article
- Comparative Analysis of Microbial Species and Multidrug Resistance Patterns in Acute Cholangitis Patients with Cholecystectomy: A Single-Center Study.Diseases (Basel, Switzerland) · 2024Article
- Clinico-epidemiological characteristics of the biliary samples and their antibiotic susceptibility pattern at a teaching hospital in Northern India.Journal of family medicine and primary care · 2023Article
- The gut microbiota: A new perspective for tertiary prevention of hepatobiliary and gallbladder diseases.Frontiers in nutrition · 2023Review
- Antimicrobial Resistance Profile of Bacteria Causing Pediatric Infections at the University Teaching Hospital in Rwanda.The American journal of tropical medicine and hygiene · 2022Article
- Changing Patterns of Causative Pathogens over Time and Efficacy of Empirical Antibiotic Therapies in Acute Cholangitis with Bacteremia.Gut and liver · 2022Article
- [Bacterial hepatobiliary infections : Pathogen spectrum, antimicrobial resistance and current treatment concepts].Der Internist · 2022Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIneffective antibiotic therapy increases mortality of acute cholangitis. The choice of antibiotics should reflect local resistance patterns and avoid the overuse of broad-spectrum agents. In this study, we analysed how results of bile and blood cultures and patient data can be used for selection of empirical antibiotic therapy in acute cholangits.
methodsPathogen frequencies and susceptibility rates were determined in 423 positive bile duct cultures and 197 corresponding blood cultures obtained from 348 consecutive patients with acute cholangitis. Patient data were retrieved from the medical records. Associations of patient and microbiological data were assessed using the Chi-2 test and multivariate binary logistic regression.
resultsIn bile cultures, enterobacterales and enterococci were isolated with equal frequencies of approximately 30% whereas in blood cultures, enterobacterales predominated (56% compared to 21% enterococci). Antibiotic resistance rates of enterobacterales were > 20% for fluorochinolones, cephalosporines and acylureidopenicillins but not for carbapenems (< 2%). The efficacy of empirical therapy was poor with a coverage of bacterial bile and blood culture isolates in 51 and 69%, respectively. By multivariate analysis, predictors for pathogen species, antibiotic susceptibility and expected antibiotic coverage were identified.
conclusionsIn unselected patients treated for acute cholangitis in a large tertiary refferential center, use of carbapenems seems necessary to achieve a high antibiotic coverage. However, by analysis of patient and microbiological data, subgroups for highly effective carbapenem-sparing therapy can be defined. For patients with community-acquired cholangitis without biliary prosthesis who do not need intensive care, piperacillin/tazobactam represents a regimen with an expected excellent antibiotic coverage.
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