Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: A randomized, controlled clinical trial

Joseph J Y Sung, Donald J. Lyon, Roamy Suen, S. C Sydney Chung, Arsenio L. Co, Augustine F B Cheng, Joseph Leung, Arthur K C Li

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

One hundred consecutive patients with acute suppurative cholangitis were randomized in a prospective, controlled clinical trial to receive either ciprofloxacin (200 mg bd iv) or triple therapy comprising ceftazidime (1 g bd iv), ampicillin (500 mg qds iv) and metronidazole (500 mg tds iv); 46 and 44 patients in the ciprofloxacin and triple therapy groups respectively were suitable for inclusion in the analysis of efficacy. In two-thirds of the patients biliary obstruction was caused by ductal calculi and in one-third by malignant or benign strictures of the biliary tract. Bacteraemia was documented in 38% of patients in the ciprofloxacin group and in 34% of patients in the triple therapy group, while bile cultures were positive in 87% and 92% of patients in the ciprofloxacin and triple therapy groups respectively. Escherichia coli, Klebsiella spp. and Enterococcus spp. were the most common biliary isolates. Eighty-five per cent of evaluable patients in the ciprofloxacin group and 77% of those in the triple therapy group responded to therapy. The mean durations of fever, septicaemic shock and hospitalization were also similar in the two treatment groups. Six (13%) patients in the ciprofloxacin group and seven (16%) in the triple therapy group required urgent endoscopy or surgery for uncontrolled infection. Recurrence of fever after an initial response was documented in one (2%) patient receiving ciprofloxacin and in three (7%) patients receiving triple therapy. The incidences of mortality were 4% in the ciprofloxacin group and 2% in the triple therapy group. The results of this study suggest that ciprofloxacin alone is adequate empirical therapy for patients with cholangitis.

Original languageEnglish (US)
Pages (from-to)855-864
Number of pages10
JournalJournal of Antimicrobial Chemotherapy
Volume35
Issue number6
DOIs
StatePublished - Jun 1995
Externally publishedYes

Fingerprint

Cholangitis
Endoscopy
Ciprofloxacin
Clinical Trials
Acute
Surgery
Escherichia coli
Therapy
Randomized Controlled Trials
Group Psychotherapy
Therapeutics
Clinical trials
Fever
Ceftazidime
Klebsiella
Metronidazole
Controlled Clinical Trials
Enterococcus
Calculi
Biliary Tract

ASJC Scopus subject areas

  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)
  • Pharmacology
  • Microbiology

Cite this

Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis : A randomized, controlled clinical trial. / Sung, Joseph J Y; Lyon, Donald J.; Suen, Roamy; Chung, S. C Sydney; Co, Arsenio L.; Cheng, Augustine F B; Leung, Joseph; Li, Arthur K C.

In: Journal of Antimicrobial Chemotherapy, Vol. 35, No. 6, 06.1995, p. 855-864.

Research output: Contribution to journalArticle

Sung, Joseph J Y ; Lyon, Donald J. ; Suen, Roamy ; Chung, S. C Sydney ; Co, Arsenio L. ; Cheng, Augustine F B ; Leung, Joseph ; Li, Arthur K C. / Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis : A randomized, controlled clinical trial. In: Journal of Antimicrobial Chemotherapy. 1995 ; Vol. 35, No. 6. pp. 855-864.
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