INVESTIGATION OF ANTIBIOTIC-PROPHYLAXIS USAGE FOR VASCULAR AND NONVASCULAR INTERVENTIONAL PROCEDURES

PURPOSE: To investigate current antibiotic prophylactic usage for arte riography, angioplasty, vascular stent placement, transjugular intrahe patic portosystemic shunt placement (TIPS), tunneled-port placement, i nferior vena cava (NC) filter placement, biliary drainage, genitourina ry drainage, abdominal drainage, and enteral tube placement with an ai m to better clarify indications and regimens for prophylaxis. METHODS: A questionnaire regarding antibiotic prophylactic usage was sent to 2 ,039 members of the Society of Cardiovascular and Interventional Radio logy (SCVIR). There were 401 respondents. Replies were evaluated for f requency and indications of prophylaxis, specific prophylaxis used, an d clarity of indications for prophylaxis. RESULTS: A majority of respo nders never used prophylaxis for arteriography, angioplasty, vascular stent placement, NC filter placement, abdominal drainage, and enteral tube placement. Infective complication rates from nonusage ranged betw een 1% and 15%. Approximately 45% always used prophylaxis for tunneled -port placement and TIPS with a 13%-16% infective complication rate am ong nonusers. In contrast, a majority of responders always used prophy laxis for biliary and genitourinary drainage, with a 40%-58% infective complication rate in nonusers. More than 70% of responders believed t hat the indications for prophylaxis were not clear for arteriography, angioplasty, vascular stent placement, tunneled-port placement, TIPS, IVC filter placement, and enteral tube placement, and in contrast, tha t the indications for prophylaxis for biliary and genitourinary draina ge were clear. Fifty-one percent of responders believed that indicatio ns for prophylaxis for abdominal drainage were clear. CONCLUSIONS: Ind ications for antibiotic prophylaxis are not clear to interventionalist s for a large number of vascular and nonvascular interventional proced ures. Prophylaxis appears unnecessary for routine arteriography, angio plasty, NC filter placement, vascular stent placement, or enterostomy tube placement. Antibiotic prophylaxis is warranted for TIPS and tunne led-port placement. Conversely, indications for antibiotic prophylaxis are clear to interventionalists for biliary and genitourinary drainag e procedures. Routine prophylaxis remains warranted for both.