Introduction
Biliary atresia, cholestatic jaundice, cholangitis
OTHER BACTERIAL INFECTION, CHOLESTATIC JAUNDICE, CHOLANGITIS
HighlightsThe severity grading system was feasible and effective in guiding empiric antibiotic therapy for post-Kasai portoenterostomy cholangitis.For mild cholangitis, cefoperazone is the first-line antibiotic.Meropenem is the optimal antibiotic treatment for moderate cholangitis.Meropenem plus immunoglobulin treatment could be used for those with severe cholangitis.Biliary atresia (BA) is a progressive fibroobliteration of the biliary tract that causes cholestatic jaundice in infantsAs with many other bacterial infections, appropriate treatment is usually guided by culture results. Unfortunately, reported positive culture rates in post-KPE cholangitis ranged from 8.9 to 26.9%In this study, we propose criteria for grading the severity of post-KPE cholangitis. The severity of cholangitis is divided into three grades at admission: mild, moderate, and severe. The empirical antibiotic regimen was selected accordingly among cefoperazone, MEPM, or MEPM+IVIG. Clinical outcomes were analyzed to determine the feasibility and efficacy of severity-guided empiric antibiotic use in the management of post-KPE cholangitis.