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01-05-2017 | Original Scientific Report

Antibiotics May be Safely Discontinued Within One Week of Percutaneous Cholecystostomy

Authors: Tyler J. Loftus, Scott C. Brakenridge, Camille G. Dessaigne, George A. Sarosi Jr., William J. Zingarelli, Frederick A. Moore, Janeen R. Jordan, Chasen A. Croft, R. Stephen Smith, Phillip A. Efron, Alicia M. Mohr

Published in: World Journal of Surgery | Issue 5/2017

Abstract

Background

For patients with acute cholecystitis managed with percutaneous cholecystostomy (PC), the optimal duration of post-procedural antibiotic therapy is unknown. Our objective was to compare short versus long courses of antibiotics with the hypothesis that patients with persistent signs of systemic inflammation 72 h following PC would receive prolonged antibiotic therapy and that antibiotic duration would not affect outcomes.

Methods

We performed a retrospective cohort analysis of 81 patients who underwent PC for acute cholecystitis at two hospitals during a 41-month period ending November 2014. Patients who received short (≤7 day) courses of post-procedural antibiotics were compared to patients who received long (>7 day) courses. Treatment response to PC was evaluated by systemic inflammatory response syndrome (SIRS) criteria. Logistic and linear regressions were used to evaluate associations between antibiotic duration and outcomes.

Results

Patients who received short (n = 30) and long courses (n = 51) of antibiotics had similar age, comorbidities, severity of cholecystitis, pre-procedural vital signs, treatment response, and culture results. There were no differences in recurrent cholecystitis (13 vs. 12%), requirement for open/converted to open cholecystectomy (23 vs. 22%), or 1-year mortality (20 vs. 18%). On logistic and linear regressions, antibiotic duration as a continuous variable was not predictive of any salient outcomes.

Conclusions

Patients who received short and long courses of post-PC antibiotics had similar baseline characteristics and outcomes. Antibiotic duration did not predict recurrent cholecystitis, interval open cholecystectomy, or mortality. These findings suggest that antibiotics may be safely discontinued within one week of uncomplicated PC.

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Title: Antibiotics May be Safely Discontinued Within One Week of Percutaneous Cholecystostomy
Authors: Tyler J. Loftus
Scott C. Brakenridge
Camille G. Dessaigne
George A. Sarosi Jr.
William J. Zingarelli
Frederick A. Moore
Janeen R. Jordan
Chasen A. Croft
R. Stephen Smith
Phillip A. Efron
Alicia M. Mohr
Publication date: 01-05-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 5/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3861-y

At a glance: The STEP trials

Springer Medicine

Antibiotics May be Safely Discontinued Within One Week of Percutaneous Cholecystostomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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