Recurrent Pyogenic Cholangitis Medication

Updated: Oct 01, 2019
  • Author: Praveen K Roy, MD, MSc; Chief Editor: Vinay K Kapoor, MBBS, MS, FRCSEd, FICS, FAMS  more...
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Medication Summary

Resolution of active infections occurring during acute episodes of recurrent pyogenic cholangitis (RPC) requires biliary drainage (ie, surgical, endoscopic, radiologic) and administration of antibiotics.


Broad-spectrum antibiotics

Class Summary

Combination agents (eg, beta-lactam plus beta-lactamase inhibitor) provide excellent gram-negative and anaerobic coverage. Antibiotic selection is guided by blood culture sensitivity whenever feasible. In patients who are allergic to penicillin, a fluoroquinolone is acceptable alternative therapy.

Piperacillin and tazobactam (Zosyn)

Antipseudomonal penicillin plus beta-lactamase inhibitor. Inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active multiplication.

Ciprofloxacin (Cipro)

Fluoroquinolone with activity against pseudomonads, streptococci, MRSA, Staphylococcus epidermidis, and most gram-negative organisms but no activity against anaerobes. Inhibits bacterial DNA synthesis and, consequently, growth. Continue treatment for at least 2 d (7-14 d typical) after signs and symptoms have disappeared