ROLE OF ANTIBIOTICS IN THE TREATMENT AND PREVENTION OF ACUTE AND RECURRENT CHOLANGITIS

Cholangitis is usually the consequence of a combination of factors: im pairment of the flow of bile and bacterial colonization of the biliary tract. Although reestablishing biliary drainage is the mainstay of tr eatment, antibiotics play an important role in the management of chola ngitis. In this review, the use of antibiotics for treatment, prophyla xis, and maintenance therapy is discussed. Antibiotics for the treatme nt of acute cholangitis should be given for 7-10 days in therapeutic d osages and may allow a more selective timing of further interventions. Antibiotic prophylaxis for cholangitis ought to be given as a single (high) dose shortly before surgical or nonsurgical manipulations of th e biliary system. Patients with a compromised biliary system (e.g., on account of an endoprothesis in situ or hepaticojejunostomy) who are p rone to develop recurrent bouts of cholangitis may benefit from antibi otic maintenance therapy, given daily in lower-than-therapeutic dosage s.