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Oral nonabsorbable antibiotics for prevention of recurrent cholangitis; a brief report study

Jesús Fortún1,2,3,4, Miguel Angel Rodríguez-Gandía5,6,7, Vicente Pintado8,5

  • 1Department of Infectious Diseases, Hospital Universitario "Ramon y Cajal", Avda Colmenar Km 9,1, Madrid, 28034, Spain. fortunabete@gmail.com.

Infection
|February 20, 2025
PubMed

Insights

Selective decontamination of the digestive tract (SDD) significantly reduced recurrent cholangitis hospitalizations by 65% in at-risk patients. This patient-friendly approach proved microbiologically safe, without increasing antibiotic resistance.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Recurrent cholangitis poses a significant risk of life-threatening sepsis.
  • Selective decontamination of the digestive tract (SDD) is an established intervention, primarily in pediatric surgery.
  • The efficacy of SDD in adult recurrent cholangitis patients requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of SDD in reducing the incidence of recurrent cholangitis requiring hospital admission.
  • To assess the safety and microbiological impact of SDD in patients with recurrent cholangitis.

Main Methods:

  • SDD, comprising colistin, tobramycin, and nystatin, was administered to eight patients with recurrent cholangitis.
  • Incidence density of cholangitis requiring hospital admission was analyzed before and after SDD administration.

Main Results:

  • The incidence density of cholangitis requiring hospital admission decreased from 1.05 to 0.37 per 100 patient-days post-SDD (RR: 0.35; p < 0.001).
  • This reduction represents a 65% decrease in the frequency and severity of cholangitis episodes.
  • No increased risk of antimicrobial resistance was observed during SDD administration.

Conclusions:

  • SDD significantly reduces the frequency and severity of recurrent cholangitis in at-risk patients.
  • The SDD protocol was well-tolerated and considered patient-friendly.
  • The intervention demonstrated microbiological safety without inducing resistance.
Abstract

Keywords:
Oral nonabsorbable antibioticsPreventionRecurrent cholangitisSelective decontamination of the digestive tract

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