trimethoprim--sulfamethoxazole-drug-combination and Biliary-Atresia

The aim of this study was to evaluate the efficacy of trimethoprim-sulfamethoxazole (TMP/SMZ) and neomycin as the prophylactic agents against the recurrence of cholangitis in children with biliary atresia (BA) after a Kasai portoenterostomy.. Nineteen BA patients aged 0 to 2 years, who had one episode of cholangitis after a Kasai portoenterostomy, were recruited in this study. Patients were assigned randomly into 2 groups: one (9 cases) with TMP/SMZ (TMP 4 mg/kg/d and SMZ 20 mg/kg/d, divided in 2 doses) and the other (10 cases) with neomycin (25 mg/kg/d, qid, 4 days a week). Another 18 BA patients aged 0 to 2 years, with cholangitis but not put on long-term prophylaxis, served as the historical control group.. The mean prophylactic periods were 14.6 months and 14.7 months in the TMP/SMZ and neomycin groups. Patients who received prophylaxis with either TMP/SMZ or neomycin had lower recurrence rates of cholangitis than those in the control group (P =.042 and.011). There was no difference in the recurrence rates of cholangitis between the TMP/SMZ and neomycin groups (P =.641). The survival rates were higher in the TMP/SMZ and neomycin groups than in the control group (P =.09 and.018).. Use of TMP/SMZ or neomycin is effective as a prophylactic agent against the recurrence of cholangitis after the Kasai portoenterostomy, but there is no difference in efficacy between these 2 regimens.

Topics: Antibiotic Prophylaxis; Biliary Atresia; Child, Preschool; Cholangitis; Drug Therapy, Combination; Female; Humans; Infant; Infant, Newborn; Life Tables; Male; Neomycin; Portoenterostomy, Hepatic; Postoperative Complications; Prospective Studies; Recurrence; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Biliary Atresia; Child; Cholangitis; Female; Half-Life; Humans; Male; Metabolic Clearance Rate; Portoenterostomy, Hepatic; Prospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination