Infections frequency

Hi I’ve been in hospital twice in the last two months for infection in the liver. After my first admission I was out of hospital for three weeks and ended up back in with another infection, it’s now two weeks since I got out of hospital and the pain came back on Sunday night, on Monday morning I went to my gp for antibiotics as this is what one of the drs in hospital suggested I do as soon as pain came back. I’ve been on antibiotics for 48 hrs now and no improvement yet in pain, though I know it’s early days yet, just don’t know if I can stick the pain. I’m just asking is getting infections this often normal and is there anything I can do to lessen frequency of infections. I did ask dr when I was in hospital and he said putting me on preventive antibiotics, but is there anything else I can do

I have had approximately 10 Cholangitis infections in the last 18 months. I had one last Monday (June 9th) and the last time I had an infection was actually twice in a span of three days - April 13th & April 15th. I went to the ER for my very first one in December 2012 and the two most recent infections. All the infections between I stayed home and suffered through them.

My doctors told me there isn’t really anything I can do to prevent them. The infections are spontaneous.

Meerkat: We feel for you, and will praying for relief! My fiance has had 3 major attacks that have taken us to the ER. There pain medicine would be given to hold him over (usually less than a day) until an ERCP could be preformed to open strictures and clear major sludge that would create a build up of gunk creating his infections. (You like that official medical term?! Lol.) This has been over several years. His doctor had given us ciprofloxacin to have on hand should symptoms began to show. At times a slight fever would come on, he'd take a pill and be fine after a few hours of discomfort. As far the the duration he took antibiotics after his cholangitis attacks, he was always prescribed 5 days minimum. Are you taking Ursodiol?

Thanks textbook and Gloria for your posts. I am on ursodiol, last time I was in hospital they increased it to 1000mg daily. When I was in hospital I was on intravenous antibiotics for 7 days, then released and on oral antibiotics for 5 more days, though they never cleared gunk (lol) away, maybe that’s why I keep getting them often!.. I must ask my dr about ciprofloxacin cause it would be useful to have that on hand, if it’s available in uk, thanks Gloria great information to think about, hope your fiancé keeps ok x

Unfortunately, there isn't a sure-fire way to prevent them. In my case I found that overexertion and a high-fat diet correlated with attacks. I made sure to not push myself too much and eat an extremely low fat diet and it seemed to help, but this may have had more to do with the natural fluctuations of the PSC itself and less to do with the changes I made. A low-fat diet is actually a really bad idea for people with PSC who are already prone to vitamin deficiency and osteoporosis, but I would become sick eating a normal diet and decided crumbling bones was preferable to itching and nausea.

When you feel the first symptoms of an attack, give your doctor a call and see if you can get a prescription of oral antibiotics (usually cipro) to try to knock it out before it gets worse and you need to make a trip to the hospital. Given the frequency of attacks, you should also inquire about a therapeutic ERCP to dilate strictures and hopefully provide some relief.

Meerkat- I was hospitalized a couple of months ago with severe jaundice due to infection. That was when they discovered my PSC had progressed to severe. I was on the IV levaquin in the hospital and given it for two more weeks to take ion release after which they did some ballooning via an ERCP and then I took another 5 days of it. I just had a second ERCP for further ballooning the smaller ducts and am currently on it again for 7 days as a precaution.

I had an ERCP at the end of April and had another infection around 40 days later, so the balloon dilation did not seem to help me. I am on Ursodiol 1000mg/day as well.

Thanks so much for the information everyone, I now feel I'll be able to ask my dr questions etc, whereas I was sort of in the dark before.

Hadn't heard of preventive (longterm?) antibiotics for cholangitis. My attacks can be months apart or days apart. I keep Cipro on hand to take x 1 wk, starting the day I get sick or the day after depending on when I can hold down more than sips of fluids.. If the episode is not clearing in 2 days, still fever and feeling rotten, I head to hospital - need a few days of IV antibiotics - PipTaz (piperacillin/tazobactam). Attack last Jan was 11 days after routine stent change (a new record for me), ended up at ER, IV abx but still not improving. ERCP done Day 4 showed R intrahepatic duct clogged with pus (gross) so 2 stents were placed in R biliary tract. Probably will continue on with 2 stents - changed every 3 or so months.. till eventual transplant. Fun stuff.