Prophylactic Oral Antibiotics in Prevention of Recurrent Cholangitis after the Kasai Portoenterostomy
Resource
JOURNAL OF PEDIATRIC SURGERY v.38 n.4 pp.590-593
Journal
JOURNAL OF PEDIATRIC SURGERY
Journal Volume
v.38
Journal Issue
n.4
Pages
590-593
Date Issued
2003
Date
2003
Author(s)
BU, LING-NAN
CHEN, HUEY-LING
CHANG, CHEE-JEN
NI, YEN-HSUAN
HSU, HONG-YUAN
LAI, HONG-SHIEE
HSU, WEN-MING
CHANG, MEI- HWEI
Abstract
PURPOSE: The aim of this study was to evaluate the efficacy of trimethoprim-sulfamethoxazole (TMP/SMZ) and neomycin as the prophylactic agents against the recurrence of cholangitis in children with biliary atresia (BA) after a Kasai portoenterostomy. METHODS: Nineteen BA patients aged 0 to 2 years, who had one episode of cholangitis after a Kasai portoenterostomy, were recruited in this study. Patients were assigned randomly into 2 groups: one (9 cases) with TMP/SMZ (TMP 4 mg/kg/d and SMZ 20 mg/kg/d, divided in 2 doses) and the other (10 cases) with neomycin (25 mg/kg/d, qid, 4 days a week). Another 18 BA patients aged 0 to 2 years, with cholangitis but not put on long-term prophylaxis , served as the historical control group. RESULTS: The mean prophylactic periods were 14.6 months and 14.7 months in the TMP/SMZ and neomycin groups. Patients who received prophylaxis with either TMP/SMZ or neomycin had lower recurrence rates of cholangitis than those in the control group (P =.042 and.011). There was no difference in the recurrence rates of cholangitis between the TMP/SMZ and neomycin groups (P =.641). The survival rates were higher in the TMP/SMZ and neomycin groups than in the control group ( P =.09 and.018 ). CONCLUSIONS: Use of TMP/SMZ or neomycin is effective as a prophylactic agent against the recurrence of cholangitis after the Kasai portoenterostomy, but there is no difference in efficacy between these 2 regimens. Copyright 2003, Elsevier Science (USA). All rights reserved.
Type
journal article