TG13 antimicrobial therapy for acute cholangitis and cholecystitis

Harumi Gomi, Joseph S. Solomkin, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Masahiro Yoshida, Shinya Kusachi, Toshihiko Mayumi, Fumihiko Miura, Seiki Kiriyama, Masamichi Yokoe, Yasutoshi Kimura, Ryota Higuchi, John A. Windsor, Christos Dervenis, Kui Hin Liau, Myung Hwan Kim

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Therapy with appropriate antimicrobial agents is an important component in the management of patients with acute cholangitis and/or acute cholecystitis. In the updated Tokyo Guidelines (TG13), we recommend antimicrobial agents that are suitable from a global perspective for management of these infections. These recommendations focus primarily on empirical therapy (presumptive therapy), provided before the infecting isolates are identified. Such therapy depends upon knowledge of both local microbial epidemiology and patient-specific factors that affect selection of appropriate agents. These patient-specific factors include prior contact with the health care system, and we separate community-acquired versus healthcare-associated infections because of the higher risk of resistance in the latter. Selection of agents for community-acquired infections is also recommended on the basis of severity (grades I-III). Free full-text articles and a mobile application of TG13 are available via

Original languageEnglish (US)
Pages (from-to)60-70
Number of pages11
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Issue number1
StatePublished - Jan 2013
Externally publishedYes


  • Acute cholangitis
  • Acute cholecystitis
  • Antimicrobial therapy
  • Biliary tract infection
  • Treatment guidelines

ASJC Scopus subject areas

  • Surgery
  • Hepatology


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