Antibiotics are typically the first-line treatment for acute cholecystitis, which people usually receive in a hospital setting. Examples include penicillins, cephalosporins, and quinolones.
Acute cholecystitis (AC) is inflammation of the gallbladder, typically due to gallstones. The condition involves infection of the biliary tract, which are the organs and ducts that produce and store bile.
After antibiotic therapy, a person may require surgery to remove their gallbladder. This prevents AC from recurring.
This article lists the different antibiotics that doctors may prescribe for AC, what to expect during treatment, and more.
According to the U.K. National Health Service (NHS), intravenous (IV) antibiotics are typically the first-line treatment for AC. People usually receive this treatment in a hospital setting.
Antibiotics help fight the bacteria causing the gallbladder infection. They do this either by killing the bacteria cells or stopping them from multiplying.
As a
The review lists seven classes of antibiotics that can help treat AC. These are outlined below.
Penicillins are a class of antibiotics derived from penicillium fungi.
Examples: This class of antibiotics includes:
- ampicillin
- amoxicillin
- piperacillin
- ticarcillin
Administration route: Oral or IV.
Tolerance: Most people tolerate penicillins well, though a
Additional information: Doctors may prescribe penicillin in combination with drugs called beta‐lactamase inhibitors, which help prevent antimicrobial resistance.
Examples of such combination drugs include:
- ampicillin/sulbactam
- amoxicillin/clavulanic acid
- piperacillin/tazobactam
Cephalosporins are broad-spectrum antibiotics that are especially effective against E. coli and Klebsiella bacteria.
Examples of cephalosporins include:
- cefazolin
- cefuroxime
- ceftriaxone
Administration route: Oral or IV.
Tolerance: Cephalosporins can cause a range of side effects, including:
- skin rash
- anaphylaxis
- fever
- inflammation of the kidneys
- granulocytopenia, which is an abnormally low level of white blood cells called granulocytes
- hemolytic anemia, which is a condition that involves the destruction of red blood cells
Carbapenems are broad-spectrum antibiotics that are effective against many bacteria, including those that are resistant to other types of antibiotics. An example is Pseudomonas.
Examples: This class of antibiotics includes:
- ertapenem
- imipenem
- meropenem
- doripenem
Administration route: IV.
Tolerance: The most common side effects of carbapenems are:
- gastrointestinal (GI) side effects, such as nausea and vomiting
- skin rash
- reactions at the IV infusion site
Quinolones are synthetic bactericidal antibiotics, meaning they work by targeting and killing bacterial cells.
Examples: This class of antibiotics includes:
- ciprofloxacin
- ofloxacin
- enoxacin
- moxifloxacin
- levofloxacin
Administration route: Oral or IV.
Tolerance: Potential side effects of quinolones include:
- GI issues, which are the
most common - increased risk of tendon rupture
- heart arrhythmias
Glycopeptide antibiotics can be effective against bacteria that are resistant to a class of antibiotics called beta-lactams.
Examples of glycopeptides
Administration route: IV, in most cases.
Tolerance: Glycopeptides can cause toxicity that affects the kidneys and inner ears. More common side effects include:
- flushing
- redness of the skin or mucous membranes
- itching of the face, neck, and upper torso
Doctors may prescribe aminoglycosides in combination with other antibiotics, such as penicillin or cephalosporin.
Examples: This class of antibiotics includes:
- streptomycin
- gentamicin
- neomycin
Administration route: IV or oral.
Tolerance: Aminoglycosides may cause toxicity that affects the kidneys and inner ear.
Doctors may prescribe metronidazole to treat serious infections involving anaerobic bacteria. These are bacteria that can
Administration route: IV or oral.
Tolerance: GI symptoms are the
A person should also
As the NHS explains, AC is a potentially serious condition that carries a high risk of complications.
Because of this, a person usually receives antibiotic treatment in a hospital setting, where a medical team can observe and monitor them closely. In most cases, antibiotic treatment may continue for up to 1 week.
Anyone receiving antibiotic treatment for AC can talk with their doctor about the type of antibiotic they are receiving and the expected length of their treatment.
Different classes of antibiotics can cause different side effects.
According to the
- skin rash
- nausea
- diarrhea
- yeast infections
More serious side effects may include:
- Clostridioides difficile (C. diff) infection, which can be life threatening and cause diarrhea that may lead to severe colon damage
- anaphylaxis
- antibiotic-resistant infections
Often, antibiotic treatment is successful in clearing the bacterial infection and reducing gallbladder inflammation.
However, many people go on to have their gallbladder surgically removed to prevent AC from recurring. Doctors refer to this procedure as cholecystectomy.
According to the National Organization for Rare Disorders (NORD), a person who does not undergo cholecystectomy following AC has a 29% chance of experiencing a second gallstone-related event within a year.
According to the NHS, antibiotics are part of the initial treatment plan for AC. Following this treatment, many people have a cholecystectomy.
The time between antibiotic treatment and cholecystectomy differs on a case-by-case basis.
Some people may require immediate surgery. Others may need to wait for their gallbladder inflammation to fully resolve, which may take several weeks.
There are two main types of cholecystectomy: open and laparoscopic.
The open type involves a surgeon removing the gallbladder via a single large incision in the abdomen.
The laparoscopic type involves a surgeon using special surgical instruments to remove the gallbladder via a series of much smaller incisions in the abdomen.
People who are unable to undergo surgery may require an alternative procedure called percutaneous cholecystostomy. This is where a doctor inserts a needle through the abdomen to drain excess fluid from the gallbladder.
Acute cholecystitis (AC) is inflammation of the gallbladder, typically due to gallstones. The condition involves infection of the biliary tract.
Antibiotics are typically the first-line treatment for AC. The type of antibiotic a person receives will depend on the type of bacterial infection they have as well as their risk of side effects. In most cases, treatment lasts up to a week.
After antibiotic treatment, most people with AC go on to have a cholecystectomy. This prevents AC from recurring.
A person can talk with a doctor about their individual treatment options and the associated risks and benefits.