RSS Feeds
Antibiotic Prophylaxis before Endoscopic Retrograde Cholangiopancreatography
- Sven J. van den Hazel, MD, PhD;
- Peter Speelman, MD, PhD; and
- Dirk J. van Leeuwen, MD, PhD
- Academic Medical Center of the University of Amsterdam, Amsterdam, the Netherlands 1105 AZ University of Alabama at Birmingham, Birmingham, AL 35294
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
We appreciate the comments of Drs. Byl and Deviere and do not disagree with their suggestion that the “inadvertent” use of antibiotics after ERCP may have masked some cases of cholangitis. However, the primary question addressed in our study was related to the need for antibiotic prophylaxis before ERCP in patients who have a low preprocedure risk for cholangitis after ERCP because they have conditions in which satisfactory drainage is usually obtained (such as distal common bile duct obstruction due to cancer or gallstone disease). Our study showed that the routine use of antibiotic prophylaxis in these patients is not justified. However, findings during ERCP or failure to accomplish adequate drainage by the time the procedure is terminated may certainly justify initiating antibiotic therapy immediately after ERCP to prevent cholangitis in these high-risk patients. We believe that such a policy is in agreement with the findings of Byl and coworkers.
Sven J. van den Hazel, MD, PhD
Peter Speelman, MD, PhD
Academic Medical Center of the University of Amsterdam; Amsterdam, the Netherlands 1105 AZ
Dirk J. van Leeuwen, MD, PhD
University of Alabama at Birmingham; Birmingham, AL 35294
- Copyright ©2004 by the American College of Physicians
