Skip to main navigation Skip to search Skip to main content

Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

  • Harumi Gomi
  • , Joseph S. Solomkin
  • , David Schlossberg
  • , Kohji Okamoto
  • , Tadahiro Takada*
  • , Steven M. Strasberg
  • , Tomohiko Ukai
  • , Itaru Endo
  • , Yukio Iwashita
  • , Taizo Hibi
  • , Henry A. Pitt
  • , Naohisa Matsunaga
  • , Yoriyuki Takamori
  • , Akiko Umezawa
  • , Koji Asai
  • , Kenji Suzuki
  • , Ho Seong Han
  • , Tsann Long Hwang
  • , Yasuhisa Mori
  • , Yoo Seok Yoon
  • Wayne Shih Wei Huang, Giulio Belli, Christos Dervenis, Masamichi Yokoe, Seiki Kiriyama, Takao Itoi, Palepu Jagannath, O. James Garden, Fumihiko Miura, Eduardo de Santibañes, Satoru Shikata, Yoshinori Noguchi, Keita Wada, Goro Honda, Avinash Nivritti Supe, Masahiro Yoshida, Toshihiko Mayumi, Dirk J. Gouma, Daniel J. Deziel, Kui Hin Liau, Miin Fu Chen, Keng Hao Liu, Cheng Hsi Su, Angus C.W. Chan, Dong Sup Yoon, In Seok Choi, Eduard Jonas, Xiao Ping Chen, Sheung Tat Fan, Chen Guo Ker, Mariano Eduardo Giménez, Seigo Kitano, Masafumi Inomata, Shuntaro Mukai, Ryota Higuchi, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto
*Corresponding author for this work
  • Mito Kyodo General Hospital
  • University of Cincinnati
  • Temple University
  • Kitakyushu City Yahata Hospital
  • Teikyo University
  • Washington University St. Louis
  • Mie Prefectural Ichishi Hospital
  • Yokohama City University
  • Oita University
  • Keio University
  • Minimally Invasive Surgery Center
  • Toho University
  • Fujinomiya City General Hospital
  • Seoul National University
  • Chang Gung Memorial Hospital
  • Kyushu University
  • Show-Chwan Memorial Hospital Taiwan
  • Loreto Nuovo Hospital
  • Agia Olga Hospital
  • Japanese Red Cross Nagoya Daini Hospital
  • Ogaki Municipal Hospital
  • Tokyo Medical University
  • Lilavati Hospital and Research Centre
  • University of Edinburgh
  • Universidad de Buenos Aires
  • Tokyo Metropolitan Komagome Hospital
  • Seth GS Medical College and KEM Hospital
  • International University of Health and Welfare
  • Japan Council for Quality Health Care
  • University of Occupational and Environmental Health, Japan
  • Academic Medical Center
  • Rush-Presbyt.-St. Luke's Med. Center
  • National University of Singapore
  • Cheng Hsin General Hospital
  • Hong Kong Sanatorium & Hospital
  • Yonsei University
  • Konyang University
  • University of Cape Town
  • Huazhong University of Science and Technology
  • Yuan's General Hospital
  • Tokyo Women's Medical University
  • Hokkaido Railway Company
  • Fujita Health University

Research output: Contribution to journalJournal Article peer-review

371 Scopus citations

Abstract

Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. The Tokyo Guidelines 2018 (TG18) provides recommendations for the appropriate use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy provided before the infecting isolates are identified. Antimicrobial agents are listed by class-definitions and TG18 severity grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored. Prudent antimicrobial usage and early de-escalation or termination of antimicrobial therapy are now important parts of decision-making. What is new in TG18 is that the duration of antimicrobial therapy for both acute cholangitis and cholecystitis is systematically reviewed. Prophylactic antimicrobial usage for elective endoscopic retrograde cholangiopancreatography is no longer recommended and the section was deleted in TG18. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

Original languageEnglish
Pages (from-to)3-16
Number of pages14
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume25
Issue number1
DOIs
StatePublished - 01 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Japanese Society of Hepato-Biliary-Pancreatic Surgery

Keywords

  • Acute cholangitis
  • Acute cholecystitis
  • Antimicrobial therapy
  • Biliary tract infection
  • Treatment guidelines

Fingerprint

Dive into the research topics of 'Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis'. Together they form a unique fingerprint.

Cite this