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Cancel that PICC line order; cholecystostomy tube and short course of antibiotics

Charles Walker1, Katelyn Young1, Ali Moosavi1

  • 1Geisinger Medical Center, USA.

American Journal of Surgery
|November 13, 2018
PubMed

Insights

Short-course antibiotics (<7 days) are as effective as long-course antibiotics (≥7 days) after cholecystostomy. This study found comparable outcomes, including infection recurrence and readmissions, supporting shorter antibiotic durations.

Area of Science:

  • Medical research
  • Infectious disease
  • Surgical outcomes

Background:

  • Current guidelines lack specific recommendations for antibiotic duration post-cholecystostomy.
  • This study addresses the need for evidence-based antibiotic duration protocols.

Purpose of the Study:

  • To compare clinical outcomes between short-course (<7 days) and long-course (≥7 days) antibiotic regimens following cholecystostomy.
  • To evaluate the safety and efficacy of reduced antibiotic duration in patients undergoing cholecystostomy.

Main Methods:

  • Retrospective review of 214 adult patients who underwent cholecystostomy between 2007 and 2017.
  • Comparison of outcomes including vital signs, laboratory values, infection rates, readmissions, and mortality between short-course and long-course antibiotic groups.

Main Results:

  • No significant differences were observed in tachycardia, leukocytosis, or time to normalization of vital signs between groups.
  • Rates of Clostridium difficile infection, cholecystitis recurrence, and gallbladder-related unplanned readmissions were similar for both short-course and long-course antibiotics.
  • Mortality rates at 30 and 90 days did not differ between the two antibiotic duration groups.

Conclusions:

  • Antibiotic treatment duration of less than 7 days is comparable in efficacy and safety to longer durations post-cholecystostomy.
  • Findings support the use of shorter antibiotic courses for intra-abdominal infections with source control, aligning with emerging medical literature.
Abstract

Keywords:
Antibiotic durationCholecystitisCholecystostomy

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