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ORIGINAL ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 3  |  Page : 408-414

Role of intraductal antibiotic in preventing cholangitis in post-endoscopic retrograde cholangiopancreatography patients


1 Nephrology Unit, Dekernes General Hospital, Egyptian Ministry of Health, Egypt
2 Department of Internal Medicine, Faculty of Medicine for Girls, Al Azhar University, Egypt
3 Department of Internal Medicine, Military Medical Academy, Cairo, Egypt

Correspondence Address:
MD Sally S Abd Elhamed
Department of Internal Medicine, Lecturer of Internal Medicine Al-Azhar University, Faculty of Medicine for Girls, 1 Elshazly St. Faisal, Giza, 11222
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_61_20

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Background Acute cholangitis is one of the most serious life-threatening post-endoscopic retrograde cholangiopancreatography (ERCP) complications.. Some have suggested that bacteria may play a role in the induction of post-ERCP cholangitis. Routine prophylactic systemic antibiotic use has an important role in reducing post-ERCP bacteremia. However, the beneficial effects of antibiotic use on preventing post-ERCP cholangitis are unclear. Aim The aim of the study was to assess post-ERCP cholangitis after intraductal antibiotic therapy in patients with obstructive jaundice. Patients and methods This cross-sectional prospective study was conducted on 60 Egyptian patients presented with obstructive jaundice who undergo elective ERCP procedure. In all, 20 patients received prophylactic intraductal 1 g ceftriaxone in contrast media; 20 patients received prophylactic intravenous ceftriaxone and 20 patients did not receive antibiotics. Pre-ERCP and post-ERCP laboratory tests and imaging were used to assess post-ERCP cholangitis. The study endpoint was developing cholangitis within 72 h after ERCP. Results There was highly significant increase in post-ERCP cholangitis in patients who did not receive antibiotics in comparison to other groups. Conclusion The use of prophylactic antibiotic prior to elective ERCP has a significant role in decreasing the frequency of post-ERCP cholangitis.


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