Shortening antibiotic duration in the treatment of acute cholangitis due to choledocholitiasis with successful biliary duct drainage
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1
surgery, St.Paraskeva medical center, Ukraine
2
Anaesthesiology and Intensive Care, Communal Municipal Clinical Hospital 8, Ukraine
3
Surgery, Zaycev V.T. “Institute of general and emergency surgery of the national academy of medical sciences of Ukraine, Ukraine
4
Surgery, Bukovinian State Medical University, Ukraine
Submission date: 2025-01-01
Final revision date: 2025-07-11
Acceptance date: 2025-08-28
Publication date: 2025-12-30
Corresponding author
Julia Fuss
surgery, St.Paraskeva medical center, Ukraine
Wiadomości Lekarskie 2025;(12):2735-2741
KEYWORDS
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ABSTRACT
Aim:
The optimal duration of antimicrobial treatment in common bile duct stone associated cholangitis is not well established. We aimed to evaluate the efficacy and safety of short duration vs 14-day antibiotic therapy in acute cholangitis associated with common bile duct stone.
Material and methods:
We divided 278 patients with all stages of acute cholangitis who underwent technically successful ERCP from January 2019 to June 2023 and had positive bile cultures into two groups: antibiotic therapy within two days of ERCP (short-course therapy, SCT; n = 48), and for >3 days (long-course therapy, LCT; n = 230).
Results:
Three recurrence occurred in STC and one recurrence occurred in LTC (p = 0.19). Clinical outcomes were similar between the two groups. The fever duration was similar between mild and moderate cholangitis within the same group and between the 2 groups. Duration of antibiotic therapy in LTC was 4.22 + 1.37 days with 39 (81.3%) needing treatment for < 5 days.
Conclusions:
Short duration antibiotic treatment based on fever resolution of 72 hours was effective and safe in patients with mild to moderate cholangitis due to common bile duct stone.