BioMed Research International / 2013 / Article / Tab 1

Review Article

Role of the Microbiota and Antibiotics in Primary Sclerosing Cholangitis

Table 1

Previously reported results of antibacterial treatment in primary sclerosing cholangitis.
(a) Clinical trials of antibacterial treatment in primary sclerosing cholangitis

Drug (reference)Year Antibiotic doseMonths of therapyChange after therapy
ALKASTALT

Metronidazole (+UDCA) [34]200439600–800 mg/day36−52.4%−41.0%−67.9%
Minocycline [35]200916200 mg/day12−19.7%−2.8%NA
Vancomycin or metronidazole [25]201318Vancomycin 125 or 250 mg qid3−42%−22%NA
17Metronidazole 250 or 500 mg tid3−10%−9%NA

(b) Case series and reports of antibacterial treatment in primary sclerosing cholangitis

Drug (reference)Year Antibiotic doseMonths of therapyChange after therapy
ALKASTALT

Tetracycline [36]*19595500 mg/day1–10−45%−60%−45%
Tetracycline [27]19655500 mg/day48 (mean)−21%NANA
Metronidazole [37]19831800 mg/day0.25NA‡‡NA‡‡NA‡‡
Sulfasalazine (+UDCA) [38]††1998230 and
45
−79%
−35%
−38%
−87%
−70%
−95%
Vancomycin [39] 19983375–1000 mg/day9 (mean)NANA−89%
Sulfasalazine (+UDCA) [40]2002150 mg/kg/day37NANA−92%
Sulfasalazine [41]200612–4.5 g/day24−74%NA−84%
Azithromycin (+UDCA) [42]20071500 mg/day, 3 days/week5−72%−31%−33%
Vancomycin [43]20081450 mg/kg/day54 ± 43NANA−78%

Key: ALK: alkaline phosphatase, AST: aspartate aminotransferase; ALT: alanine aminotransferase, GGT: γ-glutamyl transpeptidase; tid: three times a day; qid: four times a day; UDCA: ursodeoxycholic acid.
Months of treatment and followup are absolute unless otherwise indicated.
*Includes one patient who also received prednisone but was not separable from the other 4 patients.
Does not include two patients who received prednisone.
††Does not include a third patient who also received prednisolone and mizoribine.
Pediatric patients.
‡‡Original case report states there was dramatic improvement in patient’s condition, including defervescence, return of appetite, and reduction of serum bilirubin, and after 2 weeks, becoming completely asymptomatic. Six months later, patient returned with clinical worsening, which again responded to metronidazole.

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