Cancel that PICC line order; cholecystostomy tube and short course of antibiotics - 17/02/19
, Katelyn Young, Ali Moosavi, Nicholas Molacek, James Dove, Marie Hunsinger, Joseph Blansfield, Kenneth Widom, Denise Torres, James Gregory, Jeffrey WildAbstract |
Background |
Current guidelines do not specifically address optimal antibiotic duration following cholecystostomy. This study compares outcomes for short-course (<7 days) and long-course (≥7 days) antibiotics post-cholecystostomy.
Methods |
This was a retrospective review of cholecystostomy patients (≥18 years) admitted (1/1/2007-12/31/2017) to one healthcare system.
Results |
Overall, 214 patients were studied. Demographics were similar, except short-course patients had higher Charlson Comorbidity Index (p < 0.0001). There were no intergroup differences in tachycardia (22.5%[short-course] vs 23.3%[long-course]) or leukocytosis (67.1%[short-course] vs 64.4%[long-course]) at drain placement nor time to normalization for pulse, temperature or leukocytosis. There were no differences regarding Clostridium Difficile infection (5.0%[short-course] vs 1.6%[long-course]) or cholecystitis recurrence (8.8%[short-course] vs 10.9%[long-course]). No differences were observed regarding gallbladder-related unplanned readmissions (30-day:18.8%[short-course] vs 17.2%[long-course]; 90-day: 20.0%[short-course] vs 25.8%[long-course]). There were no 30- or 90-day mortality differences (overall mortality: 18.3%).
Conclusion |
Post-cholecystostomy outcomes were comparable between short-course and long-course antibiotics, consistent with emerging literature supporting short-course antibiotics for intra-abdominal infection with source control.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Cholecystostomy is as effective as cholecystectomy for critically ill patients. |
• | New research recommends a short course of antibiotics after source control has been obtained. |
• | Antibiotic duration with a cholecystostomy has not been thoroughly investigated. |
• | A short course of antibiotics is appropriate with a cholecystostomy. |
Keywords : Cholecystostomy, Cholecystitis, Antibiotic duration
Plan
Vol 217 - N° 3
P. 485-489 - mars 2019 Retour au numéro
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