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

Abstract

Background: Patients with recurrent cholangitis are at risk of developing life-threatening sepsis. Selective decontamination of the digestive tract (SDD) involving oral nonabsorbable antibiotics has been primarily applied to children undergoing Kasai portoenterostomy surgery. Methods: In this study, SDD containing colistin, tobramycin, and nystatin was administered to eight patients with recurrent cholangitis, and the incidence density before and after SDD administration was analyzed. Results: The overall incidence density of cholangitis requiring hospital admission was 0.37 per 100 patient days during the SDD period and was significantly lower than observed before SDD administration (1.05 per 100 patient days) [RR: 0.35 (95% CI: 0.21–0.59); p: <0.001, two-sided]. This was not associated with an increased risk of resistance during SDD administration. Conclusion: In this study SDD reduced by 65% the frequency and severity of recurrent cholangitis. In addition, this procedure is patient-friendly and microbiologically safe.