Prophylactic Antibiotics for Prevention of Cholangitis in Patients With Biliary Atresia Status Post-Kasai Portoenterostomy: A Systematic Review.
Katawaetee Decharun, Charles M Leys, Karen W West...
https://pubmed.ncbi.nlm.nih.gov/26183324/Actively Recruiting
Led by Children's Hospital of Fudan University · Updated on 2026-05-15
356
Participants Needed
1
Research Sites
104 weeks
Total Duration
Biliary atresia BA is a serious inflammatory disease affecting bile ducts in newborns. After Kasai portoenterostomy KP, a common treatment for BA, many patients develop cholangitis, an infection of the bile ducts. This trial investigates whether giving preventive oral antibiotics after KP reduces the rate of cholangitis compared to not using these antibiotics. The study is designed as a non-inferiority trial and follows patients for 2 years after their surgery to assess outcomes. Participants are randomly assigned to one of two groups. Both groups receive the same basic treatment including intravenous and oral medications such as sulperazone, ursodeoxycholic acid, compound glycyrrhizin, methylprednisolone, and vitamins. The antibiotics group additionally receives alternating doses of two oral antibiotics, compound sulfamethoxazole tablet and cefaclor, from 15 days after surgery until 6 months post-KP. The non-antibiotics group stops prophylactic antibiotics after surgery unless cholangitis occurs. The main focus is on measuring the occurrence of cholangitis within 6 months after KP. During the study, patients will be closely followed with regular visits and assessments over 2 years. Researchers will track cholangitis episodes, jaundice clearance, liver function, weight gain, and changes in intestinal flora at multiple time points. Laboratory tests and liver biopsies will be used to monitor liver health. The study evaluates both short-term and long-term effects to understand the benefits and risks of using preventive oral antibiotics after KP surgery in children with BA.
CONDITIONS
Preventive Effect of Prophylactic Oral Antibiotics Against Cholangitis After Kasai Portoenterostomy
G
Gong Chen, Phd
D
Di Chen
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Children's Hospital of Fudan University
Lead Sponsor
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to 1 month
Participants undergo Kasai portoenterostomy (KP) surgery and receive basic post-operative treatment including intravenous and oral medications to support liver function and prevent complications.
Hospital stay for initial surgery and early post-operative care
Duration - From 2 weeks to 6 months after surgery
Participants receive basic treatment after surgery. Those in the antibiotics group take prophylactic oral antibiotics alternating every 2 weeks from day 15 post-operation until 6 months after KP to prevent cholangitis. The non-antibiotics group receives basic treatment without prophylactic antibiotics.
Regular follow-up visits during the 6 months post-operation
Duration - Up to 2 years after surgery
Participants are monitored for cholangitis occurrence, liver function, and overall health status for up to 2 years after KP to assess long-term outcomes.
Periodic follow-up visits over 2 years
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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Lead Sponsor