Among the many causes that lead to the development of cholecystitis, the infectious nature of the disease is not the last - for example, pathogenic bacteria can get into the system of bile secretion with blood or lymph from other organs, or on a descending or ascending path from the digestive tract.
If the cholecystitis is calculous-that is, accompanied by the formation of stones in the bladder and / or ducts, then the risk of damage and inflammation of the organ wall increases several times, since concrements can mechanically injure tissues.
Treatment of cholecystitis with antibiotics is often mandatory. If the source of the infectious process is not eliminated, the disease can be complicated by the formation of an abscess, the suppuration of the bladder and ducts, which can subsequently lead to even fatal outcome. To prevent this, treatment of cholecystitis should include a complex of drugs, among which - and antibiotics.
Immediate indications for antibiotic therapy for cholecystitis are:
- marked pain in the liver, with a tendency to build up;
- a significant increase in temperature (up to + 38.5-39 ° C);
- expressed digestive disorders, with diarrhea and repeated vomiting;
- spread of pain throughout the abdomen (so-called "spilled" pain);
- presence of other infectious diseases in the patient;
- signs of the infectious process, detected as a result of a blood test.
Antibiotics for cholecystitis and pancreatitis
Antibiotics are needed in order to get rid of the infection, which often contributes to the development of cholecystitis and pancreatitis.
In uncomplicated cases, the doctor prescribes outpatient treatment with antibiotics in tablets. Such tablets can be Tetracycline, Rifampicin, Sigmamicin or Oletetrin, in individual dosages. The average course of antibiotic therapy is 7-10 days.
If surgical treatment was used for cholecystopancreatitis, an injection course of antibiotics in the form of intramuscular or intravenous drip administration is mandatory. In this case, it is appropriate to use Kanamycin, Ampicillin or Rifampicin.
In case of a complicated course of the disease, two antibiotics can be used simultaneously, or a periodic replacement of the drug after determination of the resistance of microorganisms.
Antibiotics for acute cholecystitis
In the acute course of cholecystitis, antibiotics can be useful in cases of suspected peritonitis and empyema of the gallbladder, as well as in septic complications. The doctor decides exactly which antibiotic is appropriate for acute cholecystitis. Typically, the drug is selected based on the results of sowing bile. Also of great importance is the property of the selected drug to enter the bile secretion system and concentrate in the bile to therapeutic indices.
In acute cholecystitis the most optimal 7-10-day course of therapy, with the preferred intravenous administration of medications. Recommended use of Cefuroxime, Ceftriaxone, Cefotaxime, as well as a combination of Amoxicillin and Clavulanate. Often use a treatment regimen, including cephalosporin and Metronidazole.
Antibiotics for exacerbation of cholecystitis are used according to similar schemes, with the possibility of prescribing alternative treatment:
- intravenous infusion Ampicillin 2,0 four times a day;
- intravenous infusion of gentamicin;
- intravenous infusion of metronidazole 0.5 g four times a day.
A good effect is provided by the combination of metronidazole and ciprofloxacin.
Antibiotics for chronic cholecystitis
Antibiotics in the case of chronic course of cholecystitis can be prescribed when there are signs of activity of the inflammation process in the bile secretion system. Usually, antibiotic therapy is prescribed in the stage of exacerbation of the disease, in combination with choleretic and anti-inflammatory drugs:
- Erythromycin 0.25 g four times a day;
- Oleandomycin 500 mg four times a day after meals;
- Rifampicin 0.15 g three times a day;
- Ampicillin 500 mg four to six times a day;
- Oxacillin 500 mg four to six times a day.
Such antibiotics as benzylpenicillin in the form of intramuscular injections, Phenoxymethylpenicillin in tablets, tetracycline 250 mg 4 times a day, metacyclin 300 mg twice a day, oletetrin 250 mg four times a day have a pronounced effect.
Antibiotics for calculous cholecystitis
Stones in the gall bladder not only create a mechanical barrier for the outflow of bile, but also provoke a strong irritation of the walls of the ducts and gall bladder. This can lead first to an aseptic, and then to a bacterial inflammatory process. Often such inflammation gradually acquires a chronic course with periodic exacerbations.
Often the infection enters the biliary system with blood flow. It is for this reason that patients with diseases of the urinary system, intestines, etc. Also suffer from cholecystitis. Treatment in this case involves the use of strong antimicrobial agents with a broad spectrum of activity.
Powerful antibiotics are represented by Ampiox, Erythromycin, Ampicillin, Lincomycin, Ericyclin. Such drugs are prescribed about 4 times a day, in an individually selected dosage. Oletetrin, Metacyclin is more often prescribed in chronic course of cholecystitis.