A Single Dose of Ceftriaxone Administered 30 Minutes Before Percutaneous Endoscopic Gastrostomy Significantly Reduces Local and Systemic Infective Complications

Dormann, Arno J.; Wigginghaus, Bernd; Risius, Heiko; Kleimann, Friedhelm; Kloppenborg, Axel; Grünewald, Thomas; Huchzermeyer, Hans
November 1999
American Journal of Gastroenterology;Nov1999, Vol. 94 Issue 11, p3220
Academic Journal
OBJECTIVE: The aim of this study was to determine the efficacy of antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG). METHODS: An open prospective, randomised, multicenter study was conducted in 141 patients; 72 received ceftriaxone 1 g i.v. 30 min preintervention, and 69 received no study medication. A standardized protocol was followed for PEG preparation, insertion, and aftercare; all patients received a 15-Fr gastrostomy tube. Follow-up of local and systemic infection and clinical course was continued to postintervention day 10. An aggregate erythema and exudation score >3 or the presence of pus was taken as indicative of peristomal infection. The pharmacoeconomics of antibiotic use were also examined. RESULTS: In no-prophylaxis patients, wound infection rates were 25% on day 4 and 26.4% on day 10, versus 10.1 % (p = 0.03) and 14.5% (p = 0.10), respectively, in prophylaxis patients. Results were disproportionally better in tumor patients: systemic infection rates were 16.7% versus 5.8% in no-prophylaxis versus prophylaxis patients (p = 0.045), and overall infection rates 38.9% versus 17.4%, respectively (p = 0.046). Pneumonia was more frequent in patients with underlying neurological disease. Antibiotic costs were the same in both groups (p = 0.792). CONCLUSIONS: Single dose ceftriaxone 1 g is an effective prophylaxis against local and systemic infection after PEG.


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