Document Detail


Prospective assessment of the role of antibiotic prophylaxis in ERCP.
MedLine Citation:
PMID:  16995457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Despite the existence of published recommendations, various studies of antibiotic prophylaxis have reached conflicting conclusions, and controversy exists regarding the role of antibiotic prophylaxis in ERCP. The aim of this study was to analyze the efficacy of the intramuscular administration of clindamicine and gentamicine before ERCP. METHODOLOGY: Sixty-one consecutive patients referred for ERCP were prospectively randomized to receive either clindamicine 600mg and gentamicine 80mg, both intramuscularly one hour before the ERCP (group I; 31 patients) or not (group II; 30 patients). Two blood samples were obtained from every patient (just before endoscopy and within 5 minutes of withdrawal of the endoscope) and were incubated for 7 days and examined daily for growth of bacteria. Patients were closely monitored for 7 days after endoscopy to detect the development of infectious complications. RESULTS: Only 7 cultures from 7 patients were positive. Four were obtained post-ERCP (two patients in group I and two in group II) and the remaining three before endoscopy. The post-ERCP isolated bacteria were: Streptococcus mitis, Peptoestreptococcus anaerobious, Moraxella spp and Escherichia coli. Two patients, one from each group, developed post-ERCP cholangitis that were solved with medical treatment. CONCLUSIONS: Our findings indicate that ERCP induce bacteremia in a small group of patients and suggest that prophylactic administration of clindamicine plus gentamicine does not reduce the incidence of bacteremia and cholangitis, and do not support the routine use of prophylactic antibiotics prior to ERCP.
Authors:
J Llach; J M Bordas; M Almela; M Pellisé; A Mata; M Soria; G Fernández-Esparrach; A Ginès; J I Elizalde; F Feu; J M Piqué
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  53     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-09-25     Completed Date:  2006-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  540-2     Citation Subset:  IM    
Affiliation:
Endoscopy Unit, Institut Clinic de Malalties Digestives, and Microbiology Department, Hospital Clinic i Provincial, IDIBAPS, Spain. jllach@clinic.ub.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Bacterial Agents / administration & dosage,  therapeutic use*
Antibiotic Prophylaxis*
Bacteremia / epidemiology,  etiology,  prevention & control
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
Cholangitis / epidemiology,  etiology,  prevention & control
Clindamycin / administration & dosage,  therapeutic use*
Female
Gentamicins / administration & dosage,  therapeutic use*
Humans
Incidence
Male
Middle Aged
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gentamicins; 18323-44-9/Clindamycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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