What antibiotics are prescribed for cholecystitis

Antibiotics for cholecystitis are an important part of the complex therapy of gallbladder inflammation. Symptomatic cholecystitis is manifested by abdominal pain, nausea, vomiting, fever. To stop the infection, antibacterial drugs are prescribed.

In addition to antibiotic treatment and symptomatic therapy (for example, bile-excreting drugs), it is recommended to follow a liquid, fat-free diet. In this article, we look at the symptoms and treatment and antibiotics during cholecystitis.

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Differential diagnostics

Cholecystitis is most often a consequence of advanced cholelithiasis (GSD) and requires antibiotic therapy to prevent complications in the biliary tract. So, in 20% of patients with biliary colic, who neglect treatment, an acute form of inflammatory disease develops.

If the acute form is not treated, cholecystitis gradually becomes chronic and is complicated by inflammation of neighboring organs: cholangitis, pancreatitis, cholangiohepatitis and others.

More than 90% of cases of cholecystitis are the result of gallstone blockages.

To confirm the diagnosis, ultrasound (ultrasound) of the abdominal organs is used, in addition, laboratory tests may be prescribed.

Risk factors include:

  • oral contraception,
  • pregnancy,
  • genetic predisposition,
  • obesity,
  • diabetes and other metabolic disorders,
  • liver disease.

Without the lack of timely treatment of cholecystitis, it becomes chronic. Treatment of cholecystitis is always complex and depends on the severity of the condition and the presence of complications. Most often, treatment is carried out on an outpatient basis at home, but in some cases a hospital stay and even surgical treatment may be required.

Antibiotics are used to fight the infection directly. Only a doctor can choose an effective drug based on the clinical picture and laboratory data.

Is it possible to do without antibiotics during cholecystitis?

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Cholecystitis occurs when the gallbladder wall becomes infected. That is why antibiotics are prescribed to fight infection in adults and children. Despite the fact that antibiotics for inflammation of the gallbladder by themselves are not able to cure cholecystitis, it is impossible to completely do without their use.

No folk methods will be able to suppress the focus of infection in the gallbladder, the most is to stimulate the outflow of bile, but not to cure the infection.

Moreover, without antibiotics, there is a risk that the infection will spread to neighboring organs – it will enter the bile ducts, liver, and pancreas. You can start inflammation to the point that doctors have to remove the gallbladder.

Antibiotic therapy is prescribed during the period of exacerbation of gallstone disease, treatment of calculous, acute and chronic forms of cholecystitis. Wide-spectrum drugs are used to suppress the infection as much as possible and prevent complications.

Contraindications for antibiotic therapy

All contraindications for the use of antibiotics during cholecystitis and gallstone disease are relative, which means that in case of contraindications in the patient, the doctor must choose the most appropriate alternative treatment option.

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Revision of appointments is required in the following cases:

  • a history of allergy to antibiotics of any group,
  • Infectious mononucleosis,
  • pregnancy at all stages,
  • lactation period,
  • a history of an allergic reaction to any medications,
  • severe decompensated state of the patient.

The best antibacterial drug for cholecystitis

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Many people are worried about which antibiotics are best to choose. There is no one “magic” pill for the treatment of cholecystitis.

Each drug has its own spectrum of action, features of its use, therefore, the doctor should select an antibiotic for treatment based on the symptoms and the examination performed.

There are standard protocols for the treatment of cholecystitis, which guide the choice of drugs. You can learn more about this below in the article.

Inflammation of the gallbladder is a serious illness, and self-treatment of cholecystitis is not only unacceptable, but even dangerous. To clarify the diagnosis, select a treatment regimen, additional studies can be prescribed: ultrasound, culture examination of samples (also called culture), general, biochemical blood test. Treatment of cholecystitis is always complex, but without antibiotic therapy, recovery will not come.

World standard antibacterial treatment

Most often, cholecystitis is caused by E. coli and pathogenic bacteroid B. fragilis, as well as some types of Klebsiella, enterococci, pseudomonas. Considering the peculiarities of the course of these infections, those groups of antibiotics are prescribed that have the maximum antimicrobial effect. Thus, standard treatment regimens were developed for acute cholecystitis and for exacerbation of chronic cholecystitis.

The most recommended antibiotics are:

  • piperacillin + tazobactam (Aurotaz, Zopercin, Revotaz, Tazar, Tazpen),
  • ampicillin + sulbactam (Ampisid, Sulbatsin, Unazin),
  • amoxcillin + clavulanic acid (Amoxiclav, Augmentin, Flemoklav),
  • meropenem (Alvopenem, Aris, Demopenem, Europenem, Mipenam, Merogram, Meronem, Ronem, Expenem),
  • impenem + cilastine (prepenem).

Another effective treatment regimen involves the combination of third-generation cephalosporins with metronidazole (Trichopolum), which can enhance the effect of treatment. The most commonly used cephalosporins are:

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  • cefotaxime (Cefantral, Loraxim),
  • ceftriaxone (Auroxon, Belcef, Loraxon, Cefogram),
  • ceftazidime (Aurocef, Orzid, Fortum, Ceftadim),
  • cefoperazone + sulbactam (Macrocef, Sulperazon, Sulcef),
  • cefixime (Loprax, Sortsef, Suprax, Cefix).

The listed antibiotics and trade names under which they are produced are not the only ones. In some cases, the doctor may prescribe other schemes, guided by the test results.

The drugs of the second choice are gentamicin, chloramphenicol, tetracyclines, erythromycin, and some other types of antibiotics.

In some cases, when, in addition to cholecystitis, the bile ducts (cholangitis) are inflamed or there are other complications, several antibacterial drugs can be used simultaneously. For example, combinations of penicillins with fluoroquinolones – most often ampicillin with ciprofloxacin. Or ampicillin with oxacillin (Ampiox).

Dosages of drugs depend on the severity of the infection and are selected individually. In severe cases, injections of antibacterial drugs are recommended; in lighter cases, oral forms can be taken.

Cholecystitis treatment during pregnancy and lactation

For the treatment of cholecystitis in pregnant women, those groups of antibiotics are used that are allowed for use during pregnancy. These include some penicillins, cephalosporins, and in some cases macrolides are used. The most commonly used are ampicillin + sulbactam (Ampisid, Sulbatsin, Unazin), ceftriaxone (Auroxon, Belcef, Loraxon, Cefogram), azithromycin (Sumamed, Hemomycin).

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The listed antibiotics are relatively safe for the fetus and are allowed for use during pregnancy if the expected benefits outweigh the possible harm from taking them.

But breastfeeding at the time of treatment will have to be stopped so that the child does not receive a portion of the antibiotic with milk. It is very difficult to predict the consequences, so it is worth stopping breastfeeding while the mother is taking antibacterial drugs.

In no case should you self-medicate, taking any medication without consulting a doctor. Some antibiotics can cause irreparable harm to the fetus, so only a doctor can prescribe treatment during pregnancy and lactation.

Features of admission and complications of antibiotic therapy

During treatment, one should completely abandon alcohol, adhering to a diet for cholecystitis: exclusion of fatty foods, excessive consumption of sugar, legumes, sour fruits and berries, canned food, smoked meats, spicy foods, strong coffee.

It is important to fully adhere to the treatment regimen, not to change the dosage, not to miss an appointment, not to interrupt the course, even if there is a complete recovery. Otherwise, resistance of the infection to an antibiotic may develop, a rapid relapse of the disease. Like any other drug, antibiotics have a number of side effects. More details about possible side effects are described in the instructions for the drug.

In user reviews, you can find a variety of side effects, but most often it occurs:

  • dysbiosis, which leads to disruption of the digestive tract,
  • deficiency of vitamin K, which can lead to nosebleeds,
  • candidiasis of the oral cavity and other mucous membranes (for example, thrush),
  • allergic reactions, if there is an individual sensitivity to the components of the drug (these signs cannot be ignored).

To prevent side effects, you must strictly adhere to the instructions and recommendations of your doctor. After long-term use, it is recommended to drink a course of probiotics to restore healthy intestinal microflora.


Cholecystitis, causes of appearance, its forms, symptoms, methods of diagnosis and treatment.

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General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.