Anaerobes in Biliary Tract Infections

by Matthew Songin Patient Caseson Posted on

A 45-year-old male with an unremarkable past medical history is started on empiric ceftriaxone monotherapy for suspected cholecystitis. Should metronidazole be added?

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Best Answer

No

Explanation: Routine broad anaerobic coverage may not be necessary in biliary tract infections since anaerobes are infrequently isolated and observational data suggests no difference in clinical outcomes. No significant difference was observed in 30-day mortality or 90-day relapse after adjusting for confounders (aOR 1.23, 95% CI 0.69-2.22) in a propensity score matched cohort study of 398 who did or did not receive anaerobic coverage. No anaerobes were isolated from blood or bile cultures

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