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Related Experiment Videos

Antibiotics in acute cholecystitis

H Järvinen, O V Renkonen, A Palmu

    Annals of Clinical Research
    |October 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Antibiotic bile concentrations are often inadequate in acute cholecystitis due to bile duct obstruction. Effective prophylaxis likely relies on serum and tissue levels, not bile concentrations.

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    Area of Science:

    • Surgical Infections
    • Pharmacokinetics
    • Biliary Tract Disease

    Background:

    • Acute cholecystitis frequently involves bacterial infection.
    • Gallbladder bile cultures are positive in 47% of cases.
    • Bacterial recovery rates vary significantly with operation timing.

    Purpose of the Study:

    • To evaluate antibiotic concentrations in gallbladder bile and serum during acute cholecystitis.
    • To determine the impact of cystic duct obstruction on antibiotic levels.
    • To correlate antibiotic levels with treatment outcomes.

    Main Methods:

    • Analysis of gallbladder bile and serum antibiotic levels (ampicillin, cephalothin) in patients undergoing cholecystectomy.
    • Correlation of antibiotic levels with cystic duct patency assessed by imaging and intraoperatively.

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  • In vitro susceptibility testing of isolated bacterial strains.

    • Main Results:

    • Gallbladder bile antibiotic concentrations were significantly lower in patients with acute cholecystitis and cystic duct obstruction compared to controls with patent ducts.
    • Ampicillin and cephalothin achieved inhibitory concentrations against common pathogens in vitro.
    • Serum and common duct antibiotic levels were higher than gallbladder bile levels in obstructed cases.

    Conclusions:

    • Adequate gallbladder bile antibiotic concentrations are difficult to achieve in acute cholecystitis due to bile flow obstruction.
    • Prophylactic antibiotic efficacy in reducing septic complications may depend more on systemic (serum, tissue) concentrations than on intraluminal bile concentrations.