Short vs long-course antibiotic therapy in adults with acute cholangitis:A systematic review,meta-analysis,and evidence quality assessment  

作　　者：Karampet Kasparian Chrysanthos D Christou Konstantinos Petidis Michail Doumas Olga Giouleme 

机构地区：[1]Clinic of Oncology,Gastroenterology and Hematology,Alfried Krupp Hospital,Essen 45131,Germany [2]Second Propedeutic Department of Internal Medicine,Hippokration General Hospital,Aristotle University of Thessaloniki,Thessaloniki 54642,Greece [3]Department of Transplantation Surgery,Hippokration General Hospital,Aristotle University of Thessaloniki,Thessaloniki 54642,Greece

出　　处：《World Journal of Gastroenterology》2023年第19期3027-3039,共13页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Acute cholangitis(AC)constitutes an infection with increased mortality rates in the past.Due to new diagnostic tools and therapeutic methods,the mortality of AC has been significantly reduced nowadays.The initial antibiotic treatment of AC has been oriented to the most common pathogens connected to this infection.However,the optimal duration of the antibiotic treatment of AC is still debatable.AIM To investigate if shorter-course antibiotic treatments could be similarly effective to long-course treatments in adults with AC.METHODS This study constitutes a systematic review and meta-analysis of the existing literature concerning the duration of antibiotic therapy of AC and an assessment of the quality of the evidence.The study was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses.Fifteen studies were included in the systematic review,and eight were eligible for meta-analysis.Due to heterogeneous duration cutoffs,three study-analysis groups were formed,with a cutoff of 2-3,6-7,and 14 d.RESULTS A total of 2763 patients were included in the systematic review,and 1313 were accounted for the meta-analysis.The mean age was 73.66±14.67 years,and the male and female ratio was 1:08.No significant differences were observed in the mortality rates of antibiotic treatment of 2-3 d,compared to longer treatments(odds ratio=0.78,95% confidence interval:0.23-2.67,I2=9%)and the recurrence rates and hospitalization length were also not different in all study groups.CONCLUSION Short-and long-course antibiotic treatments may be similarly effective concerning the mortality and recurrence rates of AC.Safe conclusions cannot be extracted concerning the hospitalization duration.

关 键 词：Acute cholangitis Antibiotic Short-course Long-course ANTIMICROBIAL Treatment duration 

分 类 号：R575.7[医药卫生—消化系统]