{
  "abstract": "Background and Importance Recurrent cholangitis frequently affects patients with biliary comorbidities and is associated with severe infections. The usual approach is short antibiotics cycles at symptom onset. However, oral nonabsorbable antibiotics (ONA) (colistine, nystatin and tobramycin in suspension) constitute an alternative for prevention as off-label use.Aim and Objectives The objective is to evaluate the effectiveness of ONA in reducing cholangitis recurrences and to describe adverse reactions.Material and Methods An observational, retrospective study was conducted in a third-degree hospital, including patients with recurrent cholangitis who received ONA treatment between November 2018 and August 2025. We included patients with more than one ONA pharmacy dispensation.Data were collected from the Electronic Medical Record and the Pharmacy Dispensing Program, including the number of episodes from the initial diagnosis to the study date (exitus or treatment discontinuation were registered as end date if applicable), resulting in a median of recurrences per 100 days, prior or in-treatment with ONA. Statistically significant differences between the two periods were assessed using the Wilcoxon test for nonparametric variables, considering total patients, sex, and treatment duration (<1 year vs ≥1 year).Patients‘ tolerability to the suspension was also registered, and whether it prompted any discontinuation.Results Out of the 36 patients included, 29 were male (80.5%) and the median age was 68 years (58-78).The median period of follow-up prior to ONA and once initiated were 40 months (7-72) and 8 months (4-16) respectively. During the latest, 23 (63.8%) of the patients presented at least one recurrence. Reduction of median episodes per 100 days after ONA start was statistically significant (0.72 (ICR 1.4) vs 0.46 (ICR 0.8), p=0.015). Although no statistically significant differences were observed between sexes, recurrences per 100 days did significantly increase beyond 12 months of treatment (p<0.05).Adverse events were reported in 7 patients: gastrointestinal (n=6) and cutaneous (n=1). There was one registered case of treatment discontinuation by patient decision due to severe diarrhoea.Conclusion and Relevance ONA significantly reduces cholangitis recurrences with an acceptable safety profile. However, as its effectiveness appears to decrease beyond 12 months of treatment, further studies are advisable to confirm long-term effectiveness.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "C García-Guijas-García"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "B Esteban-Cartelle"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "E Gemeno López"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "G Gómez García"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "J Sáez De La Fuente"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "M Vélez-Díaz-Pallarés"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Infectious Diseases Department, Madrid, Spain"
      ],
      "name": "J Fortún"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "A Poveda-Escolar"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramón Y Cajal- Irycis. Madrid- Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "A Álvarez-Díaz"
    }
  ],
  "title": "4CPS-220 Oral nonabsorbable antibiotics: a promising approach for prevention of recurrent cholangitis",
  "uid": "1ce6cdbc-eb8b-56d2-a3e0-79fa5ed6eded"
}