Antimicrobial therapy for acute cholangitis: Tokyo Guidelines

Atsushi Tanaka, Tadahiro Takada, Yoshifumi Kawarada, Yuji Nimura, Masahiro Yoshida, Fumihiko Miura, Masahiko Hirota, Keita Wada, Toshihiko Mayumi, Harumi Gomi, Joseph S. Solomkin, Steven M. Strasberg, Henry A. Pitt, Jacques Belghiti, Eduardo de Santibanes, Robert Padbury, Miin Fu Chen, Giulio Belli, Chen Guo Ker, Serafin C. HilvanoSheung Tat Fan, Kui Hin Liau

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)59-67
Number of pages9
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2007

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Keywords

  • Anti-infective agents
  • Biliary
  • Cholangitis
  • Guidelines
  • Infection

ASJC Scopus subject areas

  • Surgery
  • Hepatology

Cite this

Tanaka, A., Takada, T., Kawarada, Y., Nimura, Y., Yoshida, M., Miura, F., Hirota, M., Wada, K., Mayumi, T., Gomi, H., Solomkin, J. S., Strasberg, S. M., Pitt, H. A., Belghiti, J., de Santibanes, E., Padbury, R., Chen, M. F., Belli, G., Ker, C. G., ... Liau, K. H. (2007). Antimicrobial therapy for acute cholangitis: Tokyo Guidelines. Journal of Hepato-Biliary-Pancreatic Surgery, 14(1), 59-67. https://doi.org/10.1007/s00534-006-1157-6