Broad spectrum penicillin as an adequate therapy for acute cholangitis

J. E. Thompson, H. A. Pitt, J. E. Doty, J. Coleman, C. Irving

Research output: Contribution to journalArticle

Abstract

In a previous study of patients with acute cholecystitis, we demonstrated equal efficacy with a broad spectrum penicillin (piperacillin) and a penicillin plus aminoglycoside combination. Whether a single agent broad spectrum penicillin is adequate treatment for more severe infections, such as acute cholangitis, however, is still unclear. We, therefore, conducted a three center, prospective, randomized trial to determine whether or not a broad spectrum penicillin alone is adequate therapy for patients with acute cholangitis. During a 36 month period, 96 patients with sepsis and biliary obstruction were randomly assigned to receive either piperacillin (n=49) or ampicillin plus tobramycin (n=47). The two groups receiving antibiotics were similar with respect to all clinical and laboratory parameters. The incidence of blood cultures with positive results (20 versus 21 per cent) and underlying malignant lesions (51 versus 62 per cent) was also similar between the two groups. The percentage of patients with a clinical cure or significant improvement was the same in the two groups (69 versus 70 per cent). However, there was a significant difference in the cure rate between patients with benign and malignant biliary obstructions (83 versus 59 per cent, p

Original languageEnglish (US)
Pages (from-to)275-282
Number of pages8
JournalSurgery Gynecology and Obstetrics
Volume171
Issue number4
StatePublished - 1990

Fingerprint

Cholangitis
Penicillins
Piperacillin
Therapeutics
Tobramycin
Acute Cholecystitis
Aminoglycosides
Ampicillin
Sepsis
Anti-Bacterial Agents
Incidence
Infection

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Surgery

Cite this

Thompson, J. E., Pitt, H. A., Doty, J. E., Coleman, J., & Irving, C. (1990). Broad spectrum penicillin as an adequate therapy for acute cholangitis. Surgery Gynecology and Obstetrics, 171(4), 275-282.

Broad spectrum penicillin as an adequate therapy for acute cholangitis. / Thompson, J. E.; Pitt, H. A.; Doty, J. E.; Coleman, J.; Irving, C.

In: Surgery Gynecology and Obstetrics, Vol. 171, No. 4, 1990, p. 275-282.

Research output: Contribution to journalArticle

Thompson, JE, Pitt, HA, Doty, JE, Coleman, J & Irving, C 1990, 'Broad spectrum penicillin as an adequate therapy for acute cholangitis', Surgery Gynecology and Obstetrics, vol. 171, no. 4, pp. 275-282.
Thompson JE, Pitt HA, Doty JE, Coleman J, Irving C. Broad spectrum penicillin as an adequate therapy for acute cholangitis. Surgery Gynecology and Obstetrics. 1990;171(4):275-282.
Thompson, J. E. ; Pitt, H. A. ; Doty, J. E. ; Coleman, J. ; Irving, C. / Broad spectrum penicillin as an adequate therapy for acute cholangitis. In: Surgery Gynecology and Obstetrics. 1990 ; Vol. 171, No. 4. pp. 275-282.
@article{38a2031e38df48a38559b09a30b462f0,
title = "Broad spectrum penicillin as an adequate therapy for acute cholangitis",
abstract = "In a previous study of patients with acute cholecystitis, we demonstrated equal efficacy with a broad spectrum penicillin (piperacillin) and a penicillin plus aminoglycoside combination. Whether a single agent broad spectrum penicillin is adequate treatment for more severe infections, such as acute cholangitis, however, is still unclear. We, therefore, conducted a three center, prospective, randomized trial to determine whether or not a broad spectrum penicillin alone is adequate therapy for patients with acute cholangitis. During a 36 month period, 96 patients with sepsis and biliary obstruction were randomly assigned to receive either piperacillin (n=49) or ampicillin plus tobramycin (n=47). The two groups receiving antibiotics were similar with respect to all clinical and laboratory parameters. The incidence of blood cultures with positive results (20 versus 21 per cent) and underlying malignant lesions (51 versus 62 per cent) was also similar between the two groups. The percentage of patients with a clinical cure or significant improvement was the same in the two groups (69 versus 70 per cent). However, there was a significant difference in the cure rate between patients with benign and malignant biliary obstructions (83 versus 59 per cent, p",
author = "Thompson, {J. E.} and Pitt, {H. A.} and Doty, {J. E.} and J. Coleman and C. Irving",
year = "1990",
language = "English (US)",
volume = "171",
pages = "275--282",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Broad spectrum penicillin as an adequate therapy for acute cholangitis

AU - Thompson, J. E.

AU - Pitt, H. A.

AU - Doty, J. E.

AU - Coleman, J.

AU - Irving, C.

PY - 1990

Y1 - 1990

N2 - In a previous study of patients with acute cholecystitis, we demonstrated equal efficacy with a broad spectrum penicillin (piperacillin) and a penicillin plus aminoglycoside combination. Whether a single agent broad spectrum penicillin is adequate treatment for more severe infections, such as acute cholangitis, however, is still unclear. We, therefore, conducted a three center, prospective, randomized trial to determine whether or not a broad spectrum penicillin alone is adequate therapy for patients with acute cholangitis. During a 36 month period, 96 patients with sepsis and biliary obstruction were randomly assigned to receive either piperacillin (n=49) or ampicillin plus tobramycin (n=47). The two groups receiving antibiotics were similar with respect to all clinical and laboratory parameters. The incidence of blood cultures with positive results (20 versus 21 per cent) and underlying malignant lesions (51 versus 62 per cent) was also similar between the two groups. The percentage of patients with a clinical cure or significant improvement was the same in the two groups (69 versus 70 per cent). However, there was a significant difference in the cure rate between patients with benign and malignant biliary obstructions (83 versus 59 per cent, p

AB - In a previous study of patients with acute cholecystitis, we demonstrated equal efficacy with a broad spectrum penicillin (piperacillin) and a penicillin plus aminoglycoside combination. Whether a single agent broad spectrum penicillin is adequate treatment for more severe infections, such as acute cholangitis, however, is still unclear. We, therefore, conducted a three center, prospective, randomized trial to determine whether or not a broad spectrum penicillin alone is adequate therapy for patients with acute cholangitis. During a 36 month period, 96 patients with sepsis and biliary obstruction were randomly assigned to receive either piperacillin (n=49) or ampicillin plus tobramycin (n=47). The two groups receiving antibiotics were similar with respect to all clinical and laboratory parameters. The incidence of blood cultures with positive results (20 versus 21 per cent) and underlying malignant lesions (51 versus 62 per cent) was also similar between the two groups. The percentage of patients with a clinical cure or significant improvement was the same in the two groups (69 versus 70 per cent). However, there was a significant difference in the cure rate between patients with benign and malignant biliary obstructions (83 versus 59 per cent, p

UR - http://www.scopus.com/inward/record.url?scp=0025133561&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025133561&partnerID=8YFLogxK

M3 - Article

C2 - 2218831

AN - SCOPUS:0025133561

VL - 171

SP - 275

EP - 282

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 4

ER -