Biliary Tract Infections

  title={Biliary Tract Infections},
  author={J. F. Westphal and Jean Marie Brogard},
Initial therapy of acute cholecystitis and cholangitis is directed towards general support of the patient, including fluid and electrolyte replacement, correction of metabolic imbalances and antibacterial therapy.Factors affecting the efficacy of antibacterial therapy include the activity of the agent against the common biliary tract pathogens and pharmacokinetic properties such as tissue distribution and the ratio of concentration in both bile and serum to the minimum inhibitory concentration… 

Antibiotics in the Biliary Tract: A Review of the Pharmacokinetics and Clinical Outcomes of Antibiotics Penetrating the Bile and Gallbladder Wall

  • A. Thabit
  • Medicine, Biology
  • 2020
Overall, most antibiotic classes exhibit biliary penetration that translates into clinical efficacy, but three antibiotics had positive clinical outcomes despite the lack of pharmacokinetic studies on their penetration into the biliary tract.

Acute Cholecystitis Caused by Vancomycin-Resistant Enterococcus faecium in a Morbidly Obese Patient with Multiple Co-Morbidities

The first case of Vancomycin-resistant Enterococcus faecium acute cholecystitis in North America is reported, with a morbidly obese male with multiple comorbidities treated with antibiotics and ultrasound-guided percutaneous choleCystostomy tube placement.

[Acute cholangitis].

Infections of the biliary tract.

Antimicrobial management of intra-abdominal infections: literature's guidelines.

The World Society of Emergency Surgery guidelines represent the conclusions of the consensus conference held in Bologna, Italy, in July 2010 during the first congress of the WSES.

Recurrent Pyogenic Cholangitis

Recurrent pyogenic cholangitis (RPC) is an inflammatory condition of the liver and biliary tree characterized by recurrent attacks of cholangitis associated with dilation and stricturing of the

Antibiotic Use in the Intensive Care Unit: Optimization and De-Escalation

Based upon the most recent evidence, ICUs would benefit from employing empiric guidelines for antibiotic use, collecting appropriate specimens and implementing molecular diagnostics, optimizing the dosing of antibiotics, and reducing the duration of total therapy.

Role of Interventional Radiology in the Management of Acute Cholangitis.

The role of biliary drainage performed by interventional radiology to manage acute cholangitis will be the focus, with specific scenarios where percutaneous drainage should be preferred over endoscopic drainage.



Biliary sepsis. Reviewing treatment options.

The choice of an antimicrobial regimen for biliary infection should take into account the expected antibiotic sensitivities of organisms colonising bile, whether biliary obstruction or bacteraemia is present, and the activity of the antibiotic in bile.

Antibiotics in infections of the biliary tract.

It was concluded that piperacillin should be considered for antibiotic management of patients with acute cholecystitis and that further studies are necessary in patients with cholangitis to determine whether or not newer agents should replace penicillin and aminoglycoside combinations.

Antibiotics in the treatment of biliary infection.

The clinical and bacteriological aspects of biliary infection, and the excretion and efficacy of specific antibiotics in bile are described and based on the information available a therapeutic strategy is proposed.

Use of ciprofloxacin in biliary sepsis

Therapy was successful in 25 patients (including 18 with bacteremia), and failed in five patients, and the organisms and their sensitivity to ciprofloxacin are listed in Table 1.

Antibiotics, biliary sepsis, and bile duct stones.

Bacteriological study of choledochal bile in patients with common bile duct stones, with or without acute suppurative cholangitis.

The aim of the present study was to analyse the bacterial properties of choledochal bile in a large number of patients with common bile duct stones, with or without acute suppurative cholangitis, and to determine the sensitivity of the isolated bacteria to several antibiotics used in clinical practice.

Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: a randomized, controlled clinical trial.

It is suggested that ciprofloxacin alone is adequate empirical therapy for patients with cholangitis.

Broad spectrum penicillin as an adequate therapy for acute cholangitis.

Results suggest that outcome of treatment in patients with acute cholangitis is similar with either a broad spectrum penicillin or apenicillin plus aminoglycoside combination and is dependent upon the nature of the biliary obstruction.

Antibiotics in biliary disease: the relative importance of antibiotic concentrations in the bile and serum.

To reduce the septic complications of biliary operations, adequate serum levels of an effective antimicrobial are more important than an antibiotic, which is excreted almost entirely into the bile.

Acute cholangitis.

  • M. Sinanan
  • Medicine
    Infectious disease clinics of North America
  • 1992
Advances in endoscopic and transhepatic procedures have reduced the necessity for and risks associated with emergent operative biliary drainage, but patients who are delayed in diagnosis, present with septicemia, or fail to respond to conservative treatment still have substantial morbidity and death from cholangitis.