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Updates on Antibiotic Regimens in Acute Cholecystitis.
Fico, Valeria; La Greca, Antonio; Tropeano, Giuseppe; Di Grezia, Marta; Chiarello, Maria Michela; Brisinda, Giuseppe; Sganga, Gabriele.
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  • Fico V; Emergency Surgery and Trauma Center, Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences, Istituto di Ricerca e Cura a Carattere Scientifico, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy.
  • La Greca A; Emergency Surgery and Trauma Center, Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences, Istituto di Ricerca e Cura a Carattere Scientifico, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy.
  • Tropeano G; Catholic School of Medicine "Agostino Gemelli", 00168 Rome, Italy.
  • Di Grezia M; Emergency Surgery and Trauma Center, Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences, Istituto di Ricerca e Cura a Carattere Scientifico, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy.
  • Chiarello MM; Emergency Surgery and Trauma Center, Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences, Istituto di Ricerca e Cura a Carattere Scientifico, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy.
  • Brisinda G; General Surgery Operative Unit, Department of Surgery, Azienda Sanitaria Provinciale Cosenza, 87100 Cosenza, Italy.
  • Sganga G; Emergency Surgery and Trauma Center, Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences, Istituto di Ricerca e Cura a Carattere Scientifico, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy.
Medicina (Kaunas) ; 60(7)2024 Jun 25.
Article en En | MEDLINE | ID: mdl-39064469
ABSTRACT
Acute cholecystitis is one of the most common surgical diseases, which may progress from mild to severe cases. When combined with bacteremia, the mortality rate of acute cholecystitis reaches up to 10-20%. The standard of care in patients with acute cholecystitis is early laparoscopic cholecystectomy. Percutaneous cholecystostomy or endoscopic procedures are alternative treatments in selective cases. Nevertheless, antibiotic therapy plays a key role in preventing surgical complications and limiting the systemic inflammatory response, especially in patients with moderate to severe cholecystitis. Patients with acute cholecystitis have a bile bacterial colonization rate of 35-60%. The most frequently isolated microorganisms are Escherichia coli, Klebsiella spp., Streptococcus spp., Enterococcus spp., and Clostridium spp. Early empirical antimicrobial therapy along with source control of infection is the cornerstone for a successful treatment. In these cases, the choice of antibiotic must be made considering some factors (e.g., the severity of the clinical manifestations, the onset of the infection if acquired in hospital or in the community, the penetration of the drug into the bile, and any drug resistance). Furthermore, therapy must be modified based on bile cultures in cases of severe cholecystitis. Antibiotic stewardship is the key to the correct management of bile-related infections. It is necessary to be aware of the appropriate therapeutic scheme and its precise duration. The appropriate use of antibiotic agents is crucial and should be integrated into good clinical practice and standards of care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistitis Aguda / Antibacterianos Límite: Humans Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistitis Aguda / Antibacterianos Límite: Humans Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza