{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T11:03:34Z","timestamp":1756811014803,"version":"3.41.2"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The appropriate duration of antimicrobial therapy for acute cholangitis (AC) arising from multiple hilar biliary obstructions as opposed to simple obstruction in the extrahepatic bile duct has not been established. This study assessed the efficacy of the duration of antimicrobial treatments in the Tokyo Guidelines 2018 for AC based on the cause and site of obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center retrospective study involved patients with AC who underwent successful biliary drainage and completed a 7\u2010day or shorter antimicrobial treatment. Patients were categorized into three groups: Group 1, bile duct stone or benign obstruction; Group 2, simple biliary obstruction due to malignancy; and Group 3, multiple hilar biliary obstruction due to malignancy. The primary outcome was clinical cure rate, and the secondary outcomes were 3\u2010month recurrence rate and length of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 373 patients were selected. Patients in Group 3 were younger or had Charlson Comorbidity Index \u22654, and had fewer positive blood cultures. In Group 3, the clinical cure rate (87.1%) and 3\u2010month recurrence rate (32.3%) were less favorable than those in the other groups. In Group 1, the clinical cure rate was significantly higher (98.1%, <jats:italic>P<\/jats:italic>\u2009=\u20090.02) with a much lower 3\u2010month recurrence rate of only 3.4% (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than that in the other groups. The median hospital stay for all groups was 7\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that the outcomes in Group 3 may be worse than those in Groups 1 or 2, regardless of the duration of the antibiotic treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.13047","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T11:20:38Z","timestamp":1710415238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Antimicrobial therapy outcomes in acute cholangitis: Hilar multiple obstructions <i>versus<\/i> single hilar and common bile duct obstructions"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9868-162X","authenticated-orcid":false,"given":"Sakue","family":"Masuda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Imamura","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology\/Hematology, Department of Medicine Kobe University Graduate School of Medicine  Kobe Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0422-6723","authenticated-orcid":false,"given":"Ryuhei","family":"Jinushi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makomo","family":"Makazu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Kako","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1719-1352","authenticated-orcid":false,"given":"Haruki","family":"Uojima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine Kitasato University School of Medicine  Sagamihara Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikamasa","family":"Ichita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2007.064683"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1980.tb00622.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.518"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-020-06820-3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.04.074"},{"key":"e_1_2_7_7_1","article-title":"Antibiotic administration within two days after successful endoscopic retrograde cholangiopancreatography is sufficient for mild and moderate acute cholangitis","volume":"11","author":"Masuda S","year":"2022","journal-title":"J. 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