Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage
Background The current management of acute cholangitis consists of antibiotic therapy in combination with biliary drainage. However, the optimal duration of antibiotic therapy after the resolution of clinical symptoms by biliary drainage is unclear. We aimed to evaluate whether discontinuing antibio...
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| Veröffentlicht in: | Journal of gastroenterology 2011-12, Vol.46 (12), p.1411-1417 |
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| creator | Kogure, Hirofumi Tsujino, Takeshi Yamamoto, Keisuke Mizuno, Suguru Yashima, Yoko Yagioka, Hiroshi Kawakubo, Kazumichi Sasaki, Takashi Nakai, Yousuke Hirano, Kenji Sasahira, Naoki Isayama, Hiroyuki Tada, Minoru Kawabe, Takao Omata, Masao Harada, Sohei Ota, Yasuo Koike, Kazuhiko |
| description | Background
The current management of acute cholangitis consists of antibiotic therapy in combination with biliary drainage. However, the optimal duration of antibiotic therapy after the resolution of clinical symptoms by biliary drainage is unclear. We aimed to evaluate whether discontinuing antibiotic therapy for acute cholangitis immediately after the resolution of clinical symptoms, achieved by endoscopic biliary drainage, was safe and effective.
Methods
This prospective study included patients with moderate and severe acute cholangitis. Cefmetazole sodium and meropenem hydrate were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively. All patients underwent endoscopic biliary drainage within 24 h of diagnosis. When the body temperature of |
| doi_str_mv | 10.1007/s00535-011-0451-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_journals_910812770</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714586066</galeid><sourcerecordid>A714586066</sourcerecordid><originalsourceid>FETCH-LOGICAL-c556t-6f8d88e4f2c61fc7ae45e8cd543b02e337b265294d1e72a1742f5869f50bc13f3</originalsourceid><addsrcrecordid>eNp1kU1LHjEUhUOp1NePH9BNGep67L2ZZD6WImoFwU1dh0zmZozMm7xNZhT_vZGxLQUli8DJc05ycxj7inCKAM2PBCArWQJiCUJiKT-xDYqsyI7zz2wDnRAlYiP22UFKDwBYgWy_sH2OreC84htGl_RIsex1oqHQfna9C7MzxXxPUe-eCxtioc0yU2Huw6T96GaXsjpN4cn5sUiLMZSSXaaC_BCSCbvs7t3kdHwuhqid1yMdsT2rp0THb_shu7u8-HX-s7y5vbo-P7spjZT1XNa2HdqWhOWmRmsaTUJSawYpqh44VVXT81ryTgxIDdd5MG5lW3dWQm-wstUh-77m7mL4vVCa1UNYos9Xqg6hRd40kKGTFRr1RMp5G-aozdYlo84aFDkQ6jpTp-9QeQ20dSZ4si7r_xlwNZgYUopk1S66bf4FhaBe61JrXSrXpV7rUjJ7vr29d-m3NPx1_OknA3wFUj7yI8V_A32c-gKH4Z9x</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>910812770</pqid></control><display><type>article</type><title>Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kogure, Hirofumi ; Tsujino, Takeshi ; Yamamoto, Keisuke ; Mizuno, Suguru ; Yashima, Yoko ; Yagioka, Hiroshi ; Kawakubo, Kazumichi ; Sasaki, Takashi ; Nakai, Yousuke ; Hirano, Kenji ; Sasahira, Naoki ; Isayama, Hiroyuki ; Tada, Minoru ; Kawabe, Takao ; Omata, Masao ; Harada, Sohei ; Ota, Yasuo ; Koike, Kazuhiko</creator><creatorcontrib>Kogure, Hirofumi ; Tsujino, Takeshi ; Yamamoto, Keisuke ; Mizuno, Suguru ; Yashima, Yoko ; Yagioka, Hiroshi ; Kawakubo, Kazumichi ; Sasaki, Takashi ; Nakai, Yousuke ; Hirano, Kenji ; Sasahira, Naoki ; Isayama, Hiroyuki ; Tada, Minoru ; Kawabe, Takao ; Omata, Masao ; Harada, Sohei ; Ota, Yasuo ; Koike, Kazuhiko</creatorcontrib><description>Background
The current management of acute cholangitis consists of antibiotic therapy in combination with biliary drainage. However, the optimal duration of antibiotic therapy after the resolution of clinical symptoms by biliary drainage is unclear. We aimed to evaluate whether discontinuing antibiotic therapy for acute cholangitis immediately after the resolution of clinical symptoms, achieved by endoscopic biliary drainage, was safe and effective.
Methods
This prospective study included patients with moderate and severe acute cholangitis. Cefmetazole sodium and meropenem hydrate were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively. All patients underwent endoscopic biliary drainage within 24 h of diagnosis. When the body temperature of <37°C was maintained for 24 h, administration of antibiotics was stopped. The primary endpoint was the recurrence of acute cholangitis within 3 days after the withdrawal of antibiotic therapy.
Results
Eighteen patients were subjected to the final analysis. The causes of cholangitis were bile duct stone (
n
= 17) and bile duct cancer (
n
= 1). The severity of acute cholangitis was moderate in 14 patients and severe in 4. Body temperature of <37°C was achieved in all patients after a median of 2 days (range 1–6) following endoscopic biliary drainage. Antibiotic therapy was administered for a median duration of 3 days (range 2–7). None of the patients developed recurrent cholangitis within 3 days after the withdrawal of antibiotics.
Conclusions
Fever-based antibiotic therapy for acute cholangitis is safe and effective when resolution of fever is achieved following endoscopic biliary drainage.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-011-0451-5</identifier><identifier>PMID: 21842232</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Abdominal Surgery ; Acute Disease ; Aged ; Aged, 80 and over ; Analysis ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - adverse effects ; Anti-Bacterial Agents - therapeutic use ; Biliary Tract ; Cefmetazole ; Cefmetazole - therapeutic use ; Cholangiopancreatography, Endoscopic Retrograde - methods ; Cholangitis - etiology ; Cholangitis - pathology ; Cholangitis - surgery ; Colorectal Surgery ; Drainage - methods ; Female ; Fever - drug therapy ; Fever - etiology ; Gastroenterology ; Hepatology ; Humans ; Male ; Medical colleges ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Original Article—Liver ; Pancreas ; Prospective Studies ; Recurrence ; Severity of Illness Index ; Surgical Oncology ; Thienamycins - therapeutic use ; Treatment Outcome</subject><ispartof>Journal of gastroenterology, 2011-12, Vol.46 (12), p.1411-1417</ispartof><rights>Springer 2011</rights><rights>COPYRIGHT 2011 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c556t-6f8d88e4f2c61fc7ae45e8cd543b02e337b265294d1e72a1742f5869f50bc13f3</citedby><cites>FETCH-LOGICAL-c556t-6f8d88e4f2c61fc7ae45e8cd543b02e337b265294d1e72a1742f5869f50bc13f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-011-0451-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-011-0451-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21842232$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kogure, Hirofumi</creatorcontrib><creatorcontrib>Tsujino, Takeshi</creatorcontrib><creatorcontrib>Yamamoto, Keisuke</creatorcontrib><creatorcontrib>Mizuno, Suguru</creatorcontrib><creatorcontrib>Yashima, Yoko</creatorcontrib><creatorcontrib>Yagioka, Hiroshi</creatorcontrib><creatorcontrib>Kawakubo, Kazumichi</creatorcontrib><creatorcontrib>Sasaki, Takashi</creatorcontrib><creatorcontrib>Nakai, Yousuke</creatorcontrib><creatorcontrib>Hirano, Kenji</creatorcontrib><creatorcontrib>Sasahira, Naoki</creatorcontrib><creatorcontrib>Isayama, Hiroyuki</creatorcontrib><creatorcontrib>Tada, Minoru</creatorcontrib><creatorcontrib>Kawabe, Takao</creatorcontrib><creatorcontrib>Omata, Masao</creatorcontrib><creatorcontrib>Harada, Sohei</creatorcontrib><creatorcontrib>Ota, Yasuo</creatorcontrib><creatorcontrib>Koike, Kazuhiko</creatorcontrib><title>Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
The current management of acute cholangitis consists of antibiotic therapy in combination with biliary drainage. However, the optimal duration of antibiotic therapy after the resolution of clinical symptoms by biliary drainage is unclear. We aimed to evaluate whether discontinuing antibiotic therapy for acute cholangitis immediately after the resolution of clinical symptoms, achieved by endoscopic biliary drainage, was safe and effective.
Methods
This prospective study included patients with moderate and severe acute cholangitis. Cefmetazole sodium and meropenem hydrate were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively. All patients underwent endoscopic biliary drainage within 24 h of diagnosis. When the body temperature of <37°C was maintained for 24 h, administration of antibiotics was stopped. The primary endpoint was the recurrence of acute cholangitis within 3 days after the withdrawal of antibiotic therapy.
Results
Eighteen patients were subjected to the final analysis. The causes of cholangitis were bile duct stone (
n
= 17) and bile duct cancer (
n
= 1). The severity of acute cholangitis was moderate in 14 patients and severe in 4. Body temperature of <37°C was achieved in all patients after a median of 2 days (range 1–6) following endoscopic biliary drainage. Antibiotic therapy was administered for a median duration of 3 days (range 2–7). None of the patients developed recurrent cholangitis within 3 days after the withdrawal of antibiotics.
Conclusions
Fever-based antibiotic therapy for acute cholangitis is safe and effective when resolution of fever is achieved following endoscopic biliary drainage.</description><subject>Abdominal Surgery</subject><subject>Acute Disease</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biliary Tract</subject><subject>Cefmetazole</subject><subject>Cefmetazole - therapeutic use</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - methods</subject><subject>Cholangitis - etiology</subject><subject>Cholangitis - pathology</subject><subject>Cholangitis - surgery</subject><subject>Colorectal Surgery</subject><subject>Drainage - methods</subject><subject>Female</subject><subject>Fever - drug therapy</subject><subject>Fever - etiology</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Original Article—Liver</subject><subject>Pancreas</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Severity of Illness Index</subject><subject>Surgical Oncology</subject><subject>Thienamycins - therapeutic use</subject><subject>Treatment Outcome</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1LHjEUhUOp1NePH9BNGep67L2ZZD6WImoFwU1dh0zmZozMm7xNZhT_vZGxLQUli8DJc05ycxj7inCKAM2PBCArWQJiCUJiKT-xDYqsyI7zz2wDnRAlYiP22UFKDwBYgWy_sH2OreC84htGl_RIsex1oqHQfna9C7MzxXxPUe-eCxtioc0yU2Huw6T96GaXsjpN4cn5sUiLMZSSXaaC_BCSCbvs7t3kdHwuhqid1yMdsT2rp0THb_shu7u8-HX-s7y5vbo-P7spjZT1XNa2HdqWhOWmRmsaTUJSawYpqh44VVXT81ryTgxIDdd5MG5lW3dWQm-wstUh-77m7mL4vVCa1UNYos9Xqg6hRd40kKGTFRr1RMp5G-aozdYlo84aFDkQ6jpTp-9QeQ20dSZ4si7r_xlwNZgYUopk1S66bf4FhaBe61JrXSrXpV7rUjJ7vr29d-m3NPx1_OknA3wFUj7yI8V_A32c-gKH4Z9x</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Kogure, Hirofumi</creator><creator>Tsujino, Takeshi</creator><creator>Yamamoto, Keisuke</creator><creator>Mizuno, Suguru</creator><creator>Yashima, Yoko</creator><creator>Yagioka, Hiroshi</creator><creator>Kawakubo, Kazumichi</creator><creator>Sasaki, Takashi</creator><creator>Nakai, Yousuke</creator><creator>Hirano, Kenji</creator><creator>Sasahira, Naoki</creator><creator>Isayama, Hiroyuki</creator><creator>Tada, Minoru</creator><creator>Kawabe, Takao</creator><creator>Omata, Masao</creator><creator>Harada, Sohei</creator><creator>Ota, Yasuo</creator><creator>Koike, Kazuhiko</creator><general>Springer Japan</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20111201</creationdate><title>Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage</title><author>Kogure, Hirofumi ; Tsujino, Takeshi ; Yamamoto, Keisuke ; Mizuno, Suguru ; Yashima, Yoko ; Yagioka, Hiroshi ; Kawakubo, Kazumichi ; Sasaki, Takashi ; Nakai, Yousuke ; Hirano, Kenji ; Sasahira, Naoki ; Isayama, Hiroyuki ; Tada, Minoru ; Kawabe, Takao ; Omata, Masao ; Harada, Sohei ; Ota, Yasuo ; Koike, Kazuhiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c556t-6f8d88e4f2c61fc7ae45e8cd543b02e337b265294d1e72a1742f5869f50bc13f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdominal Surgery</topic><topic>Acute Disease</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biliary Tract</topic><topic>Cefmetazole</topic><topic>Cefmetazole - therapeutic use</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - methods</topic><topic>Cholangitis - etiology</topic><topic>Cholangitis - pathology</topic><topic>Cholangitis - surgery</topic><topic>Colorectal Surgery</topic><topic>Drainage - methods</topic><topic>Female</topic><topic>Fever - drug therapy</topic><topic>Fever - etiology</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Original Article—Liver</topic><topic>Pancreas</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Severity of Illness Index</topic><topic>Surgical Oncology</topic><topic>Thienamycins - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kogure, Hirofumi</creatorcontrib><creatorcontrib>Tsujino, Takeshi</creatorcontrib><creatorcontrib>Yamamoto, Keisuke</creatorcontrib><creatorcontrib>Mizuno, Suguru</creatorcontrib><creatorcontrib>Yashima, Yoko</creatorcontrib><creatorcontrib>Yagioka, Hiroshi</creatorcontrib><creatorcontrib>Kawakubo, Kazumichi</creatorcontrib><creatorcontrib>Sasaki, Takashi</creatorcontrib><creatorcontrib>Nakai, Yousuke</creatorcontrib><creatorcontrib>Hirano, Kenji</creatorcontrib><creatorcontrib>Sasahira, Naoki</creatorcontrib><creatorcontrib>Isayama, Hiroyuki</creatorcontrib><creatorcontrib>Tada, Minoru</creatorcontrib><creatorcontrib>Kawabe, Takao</creatorcontrib><creatorcontrib>Omata, Masao</creatorcontrib><creatorcontrib>Harada, Sohei</creatorcontrib><creatorcontrib>Ota, Yasuo</creatorcontrib><creatorcontrib>Koike, Kazuhiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kogure, Hirofumi</au><au>Tsujino, Takeshi</au><au>Yamamoto, Keisuke</au><au>Mizuno, Suguru</au><au>Yashima, Yoko</au><au>Yagioka, Hiroshi</au><au>Kawakubo, Kazumichi</au><au>Sasaki, Takashi</au><au>Nakai, Yousuke</au><au>Hirano, Kenji</au><au>Sasahira, Naoki</au><au>Isayama, Hiroyuki</au><au>Tada, Minoru</au><au>Kawabe, Takao</au><au>Omata, Masao</au><au>Harada, Sohei</au><au>Ota, Yasuo</au><au>Koike, Kazuhiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>46</volume><issue>12</issue><spage>1411</spage><epage>1417</epage><pages>1411-1417</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
The current management of acute cholangitis consists of antibiotic therapy in combination with biliary drainage. However, the optimal duration of antibiotic therapy after the resolution of clinical symptoms by biliary drainage is unclear. We aimed to evaluate whether discontinuing antibiotic therapy for acute cholangitis immediately after the resolution of clinical symptoms, achieved by endoscopic biliary drainage, was safe and effective.
Methods
This prospective study included patients with moderate and severe acute cholangitis. Cefmetazole sodium and meropenem hydrate were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively. All patients underwent endoscopic biliary drainage within 24 h of diagnosis. When the body temperature of <37°C was maintained for 24 h, administration of antibiotics was stopped. The primary endpoint was the recurrence of acute cholangitis within 3 days after the withdrawal of antibiotic therapy.
Results
Eighteen patients were subjected to the final analysis. The causes of cholangitis were bile duct stone (
n
= 17) and bile duct cancer (
n
= 1). The severity of acute cholangitis was moderate in 14 patients and severe in 4. Body temperature of <37°C was achieved in all patients after a median of 2 days (range 1–6) following endoscopic biliary drainage. Antibiotic therapy was administered for a median duration of 3 days (range 2–7). None of the patients developed recurrent cholangitis within 3 days after the withdrawal of antibiotics.
Conclusions
Fever-based antibiotic therapy for acute cholangitis is safe and effective when resolution of fever is achieved following endoscopic biliary drainage.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>21842232</pmid><doi>10.1007/s00535-011-0451-5</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of gastroenterology, 2011-12, Vol.46 (12), p.1411-1417 |
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| subjects | Abdominal Surgery Acute Disease Aged Aged, 80 and over Analysis Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - adverse effects Anti-Bacterial Agents - therapeutic use Biliary Tract Cefmetazole Cefmetazole - therapeutic use Cholangiopancreatography, Endoscopic Retrograde - methods Cholangitis - etiology Cholangitis - pathology Cholangitis - surgery Colorectal Surgery Drainage - methods Female Fever - drug therapy Fever - etiology Gastroenterology Hepatology Humans Male Medical colleges Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Original Article—Liver Pancreas Prospective Studies Recurrence Severity of Illness Index Surgical Oncology Thienamycins - therapeutic use Treatment Outcome |
| title | Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage |
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