Chronic Antibiotic Prophylaxis to Prevent Recurrent Cholangitis in Liver Transplant Recipients

ABSTRACT Objective To evaluate the use of prolonged antibiotic prophylaxis (AP) on the prevention of recurrent biliary tract infection (BTI) in liver transplant recipients (LTR). Methods A single‐center retrospective case series study from 2009 to 2023 was conducted to assess the effect of AP on the prevention of recurrent BTI in LTR. Results A total of 15 patients who underwent liver transplantation (LT) were evaluated and treated with a prolonged course of AP (mean 77 months). Ten of fifteen (66.6%) patients experienced resolution of episodes of BTI while on AP. Three additional patents noted a marked decrease in the frequency of recurrent BTI. The AP was well tolerated with few adverse events. A rescue antibiotic strategy was provided for each patient on AP in case of breakthrough infection. Conclusion Prolonged AP appears to be an efficacious and safe method to prevent recurrent BTI in LTR, reducing admissions to the hospital. This approach requires more rigorous testing in a randomized clinical trial.