Are antibiotics necessary in acute cholecystitis?

Area of Science:

• Surgical Gastroenterology
• Infectious Disease Management

Background:

• Acute cholecystitis is a common surgical emergency.
• The role of prophylactic and therapeutic antibiotics in managing acute cholecystitis requires clarification.

Purpose of the Study:

• To evaluate the efficacy of antibiotic therapy in reducing complications of acute cholecystitis.
• To identify patient subgroups who benefit from antibiotic administration.

Main Methods:

• Retrospective analysis of 302 cases of acute cholecystitis.
• Assessment of antibiotic use versus outcomes, including local septic complications, wound infections, and septicaemia.

Main Results:

• Antibiotics showed no significant impact on preventing local septic complications like empyema or abscesses.
• Antibiotic administration was associated with a reduced incidence of wound infections and septicaemia in high-risk patients.
• High-risk patients were defined as those over 60 years, with debilitating diseases, or pre-existing septic complications.

Conclusions:

• Antibiotics are not indicated for uncomplicated acute cholecystitis in patients under 60.
• Antibiotic therapy is beneficial for reducing infectious complications in high-risk patients with acute cholecystitis.