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Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

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单位: [1]Univ Tsukuba, Mito Kyodo Gen Hosp, Ctr Global Hlth, Tsukuba, Ibaraki, Japan [2]Univ Cincinnati, Coll Med, Dept Surg, Cincinnati, OH USA [3]Temple Univ, Lewis Katz Sch Med, Philadelphia, PA 19122 USA [4]Kitakyushu City Yahata Hosp, Dept Surg, Ctr Gastroenterol & Liver Dis, Fukuoka, Japan [5]Teikyo Univ, Sch Med, Dept Surg, Tokyo, Japan [6]Washington Univ, Sect HPB Surg, St Louis, MO USA [7]Mie Prefectural Ichishi Hosp, Dept Family Med, Tsu, Mie, Japan [8]Yokohama City Univ, Dept Surg Gastroenterol, Grad Sch Med, Yokohama, Kanagawa, Japan [9]Oita Univ, Dept Gastroenterol & Pediat Surg, Fac Med, Oita, Japan [10]Keio Univ, Dept Surg, Sch Med, Tokyo, Japan [11]Teikyo Univ, Dept Infect Control & Prevent, Tokyo, Japan [12]Teikyo Univ, Dept Internal Med, Sch Med, Tokyo, Japan [13]Yotsuya Med Cube, Minimally Invas Surg Ctr, Tokyo, Japan [14]Toho Univ, Dept Surg, Ohashi Med Ctr, Tokyo, Japan [15]Fujinomiya City Gen Hosp, Dept Surg, Shizuoka, Japan [16]Seoul Natl Univ, Coll Med, Dept Surg, Bundang Hosp, Seoul, South Korea [17]Linkou Chang Gung Mem Hosp, Div Gen Surg, Taoyuan, Taiwan [18]Kyushu Univ, Grad Sch Med Sci, Dept Surg & Oncol, Fukuoka, Japan [19]Show Chwan Mem Hosp, Dept Surg, Changhua, Taiwan [20]Loreto Nuovo Hosp, Dept Gen & HPB Surg, Naples, Italy [21]Agia Olga Hosp, Dept Surg 1, Athens, Greece [22]Japanese Red Cross Nagoya Daini Hosp, Dept Gen Internal Med, Nagoya, Aichi, Japan [23]Ogaki Municipal Hosp, Dept Gastroenterol, Gifu, Japan [24]Tokyo Med Univ Hosp, Dept Gastroenterol & Hepatol, Tokyo, Japan [25]Lilavati Hosp & Res Ctr, Dept Surg Oncol, Bombay, Maharashtra, India [26]Univ Edinburgh, Surg Clin, Edinburgh, Midlothian, Scotland [27]Univ Buenos Aires, Hosp Italiano, Dept Surg, Buenos Aires, DF, Argentina [28]Mie Prefectural Ichishi Hosp, Tsu, Mie, Japan [29]Tokyo Metropolitan Komagome Hosp, Dept Surg, Tokyo, Japan [30]Seth GS Med Coll & KEM Hosp, Dept Surg Gastroenterol, Bombay, Maharashtra, India [31]Int Univ Hlth & Welf, Ichikawa Hosp, Dept Hemodialysis & Surg, Chiba, Japan [32]Japan Council Qual Hlth Care, Dept EBM & Guidelines, Tokyo, Japan [33]Univ Occupat & Environm Hlth, Dept Emergency Med, Sch Med, Fukuoka, Japan [34]Acad Med Ctr, Dept Surg, Amsterdam, Netherlands [35]Rush Univ, Med Ctr, Dept Surg, Chicago, IL 60612 USA [36]Mt Elizabeth Novena Hosp, Liau KH Consulting PL, Singapore, Singapore [37]Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore [38]Cheng Hsin Gen Hosp, Dept Surg, Taipei, Taiwan [39]Hong Kong Sanat & Hosp, Dept Surg, Surg Ctr, Hong Kong, Hong Kong, Peoples R China [40]Yonsei Univ, Gangnam Severance Hosp, Dept Surg, Seoul, South Korea [41]Konyang Univ Hosp, Dept Surg, Daejeon, South Korea [42]Univ Cape Town, Surg Gastroenterol Hepatopancreatobiliary Unit, Cape Town, South Africa [43]Groote Schuur Hosp, Cape Town, South Africa [44]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Hepat Surg Ctr,Dept Surg, Wuhan, Hubei, Peoples R China [45]Hong Kong Sanat & Hosp, Liver Surg Ctr, Hong Kong, Hong Kong, Peoples R China [46]Yuans Gen Hosp, Dept Surg, Kaohsiung, Taiwan [47]Univ Buenos Aires, Chair Gen Surg & Minimal Invas Surg Taquini, DAICIM Fdn, Buenos Aires, DF, Argentina [48]Oita Univ, Oita, Japan [49]Tokyo Womens Med Univ, Dept Surg, Inst Gastroenterol, Tokyo, Japan [50]JR Sapporo Hosp, Dept Surg, Sapporo, Hokkaido, Japan [51]Fujita Hlth Univ, Teaching Hosp 2, Dept Gastroenterol, Toyoake, Aichi, Japan [52]Toho Univ, Tokyo, Japan
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关键词: Acute cholangitis Acute cholecystitis Antimicrobial therapy Biliary tract infection Treatment guidelines

摘要:
Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. The Tokyo Guidelines 2018 (TG18) provides recommendations for the appropriate use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy provided before the infecting isolates are identified. Antimicrobial agents are listed by class-definitions and TG18 severity grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored. Prudent antimicrobial usage and early de-escalation or termination of antimicrobial therapy are now important parts of decision-making. What is new in TG18 is that the duration of antimicrobial therapy for both acute cholangitis and cholecystitis is systematically reviewed. Prophylactic antimicrobial usage for elective endoscopic retrograde cholangiopancreatography is no longer recommended and the section was deleted in TG18. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47 . Related clinical questions and references are also included.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 2 区 外科 3 区 胃肠肝病学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 胃肠肝病学 3 区 外科
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出版当年[2016]版:
Q2 SURGERY Q3 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q1 SURGERY Q2 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者单位: [1]Univ Tsukuba, Mito Kyodo Gen Hosp, Ctr Global Hlth, Tsukuba, Ibaraki, Japan
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通讯机构: [5]Teikyo Univ, Sch Med, Dept Surg, Tokyo, Japan [*1]Teikyo Univ, Sch Med, Dept Surg, Itabashi Ku, 2-11-1 Kaga, Tokyo 1738605, Japan
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