Antibiotic prophylaxis for percutaneous endoscopic gastrostomy for non‐malignant conditions: a double‐blind prospective randomized controlled trial

作者：Adnan A. Saadeddin, Dennis A. Freshwater, Neil C Fisher, Barry J.M. Jones · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2005 · DOI：10.1111/j.1365-2036.2005.02578.x · 被引用次数：64 · 研究领域：Clinical Nutrition and Gastroenterology、Cerebral Palsy and Movement Disorders、Nutrition and Health in Aging

BACKGROUND: The use of antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy insertion has been encouraged following development of guidelines by a number of professional societies within the past few years. However, not all evidence supports routine prophylaxis, particularly in patients with 'benign' disease indications for percutaneous endoscopic gastrostomy insertion. AIM: To identify whether prophylactic antibiotic usage is beneficial in patients undergoing percutaneous endoscopic gastrostomy insertion without malignant disease. METHODS: Adult patients without malignant disease who were referred for percutaneous endoscopic gastrostomy insertion at our unit were assessed for participation in this prospective, double-blind, randomized controlled study. Patients were randomized to receive either placebo or 2.2 g co-amoxiclav (or 2 g cefotaxime if penicillin-allergic) at time of percutaneous endoscopic gastrostomy insertion. Clinical endpoints studies were percutaneous endoscopic gastrostomy site or systemic infection and death within 7 days of percutaneous endoscopic gastrostomy insertion. Results : Ninety-nine patients completed the study (51 antibiotics, 48 placebo). Outcomes in the antibiotic and placebo groups respectively were: percutaneous endoscopic gastrostomy site infection, 11% vs. 47% (P < 0.01); systemic infection, 16% vs. 38% (P < 0.05); and death, 8% vs. 15% (P = 0.5). CONCLUSIONS: Antibiotic prophylaxis prior to percutaneous endoscopic gastrostom...