Original articleAminoglycoside nephrotoxicity in obstructive jaundice
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2013, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :The traditional antibiotic regimen for cholangitis comprised a combination of an aminoglycoside and ampicillin. However, because of high rates of drug toxicity and emerging drug resistance,63,64 these have largely been replaced by more efficacious regimens such as broad-spectrum penicillins, cephalosporins, and fluoroquinolones. Extended-spectrum penicillins, such as piperacillin, are effective against the common organisms causing cholangitis, including aerobic and anaerobic gram-negative bacilli, and Enterococcus species.
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2006, Gastroenterology Clinics of North AmericaCitation Excerpt :Antibiotics do not reach the biliary system until about 24 hours after drainage has been accomplished. Broad-spectrum coverage is preferred and although the combination of ampicillin and gentamicin is popular, there are disadvantages: limited anaerobic coverage, frequent microbial resistance, and nephrotoxicity [50]. In extremely ill or elderly patients, anaerobic coverage is added because a mixed infection is likely.
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