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Antimicrobial therapy for acute cholangitis: Tokyo Guidelines
Author(s) -
Tanaka Atsushi,
Takada Tadahiro,
Kawarada Yoshifumi,
Nimura Yuji,
Yoshida Masahiro,
Miura Fumihiko,
Hirota Masahiko,
Wada Keita,
Mayumi Toshihiko,
Gomi Harumi,
Solomkin Joseph S.,
Strasberg Steven M.,
Pitt Henry A.,
Belghiti Jacques,
Santibanes Eduardo,
Padbury Robert,
Chen MiinFu,
Belli Giulio,
Ker ChenGuo,
Hilvano Serafin C.,
Fan SheungTat,
Liau KuiHin
Publication year - 2007
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-006-1157-6
Subject(s) - antimicrobial , medicine , anti infective agents , intensive care medicine , antibiotics , microbiology and biotechnology , biology
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.