Intravenous antibiotics for the treatments of cholangitis after Kasai operation in biliary atresia patients

Abstract Objective: This is a single-center, retrospective study, to assess the experimental treatment of intravenous antibiotics for cholangitis after Kasai portoenterostomy (PKE) in biliary atresia (BA) patients.Methods: 153 cholangitis patients after PKE from January 2016 to December 2018 were retrospectively reviewed. Based on the different kinds of antibiotics treatment, all patients were divided into 3 groups: Intravenous Cefoperazone Sodium Tazobactam Sodium (ICSTS) group, Intravenous Meropenem (IMP) group, Meropenem combined with Intravenous immunoglobulin (IVIG) group, compared the tre atment effect among 3 groups.Results: The recurrent cholangitis rate of ICSTS group, IMP group and IVIG group is 28.9%,39.4%, 85.7% respectively. The IVIG group had higher temperature (T), white blood cell (WBC), C-reactive protein (CRP), alanine transaminase (ALT) and aspartate transaminase (AST) lever than ICSTS group and IMP group (P <0.05) before interference. The antifebrile rate had no significant difference among 3 groups after 3 days hospitalization, as we expected, the level of WBC, CRP, DBL was significant descend in each group, the level of ALT, AST, γ-GGT was obviously decline in IVIG group. After 3 months followed-up, IVIG group showed a recurrent rate of 82%, which was higher than ICSTS group and IMP group (P=0.013), the cholangitis frequency was significant higher in IVIG group than ICSTS group and IMP group (P<0.05).Conclusions: Personalized intravenous antibiotics to treat cholangitis considering recurrent episode, the severity of infection and liver function, may be a more appropriate treatment strategy.