G. Preclik et al., Prospective, randomised, double blind trial of prophylaxis with single dose of co-amoxiclav before percutaneous endoscopic gastrostomy, BR MED J, 319(7214), 1999, pp. 881-884
Citations number
18
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objective To determine the efficacy of antibacterial prophylaxis in prevent
ing infectious complications after percutaneous endoscopic gastrostomy.
Design Prospective, randomised, placebo controlled, double blind, multicent
re study.
Setting Departments of internal medicine at six German hospitals.
Subjects Of 106 randomised adult patients with dysphagia, 97 received study
medication, and 84 completed the study. The median age of the patients was
65 years. Most had dysphagia due to malignant disease (65%), and many (76%
) had serious comorbidity.
Interventions A single intravenous 2.2 g dose of co-amoxiclav or identical
appearing saline was given 30 min before percutaneous endoscopic gastrostom
y performed by the thread pull method.
Main outcome measures Occurrence of peristomal wound infections and other i
nfections within one week after percutaneous endoscopic gastrostomy.
Results The incidence of peristomal and other infections within one week af
ter percutaneous endoscopic gastrostomy was significantly reduced in the an
tibiotic group (8/41 (20%) v 28/43 (65%), P < 0.001), Similar results were
obtained in an intention to treat analysis. Several peristomal wound infect
ions were of minor clinical significance. After wound infections that requi
red no or only local treatment were excluded from the analysis, antibiotic
prophylaxis remained highly effective in reducing clinically important woun
d infections (1/41 (2%) v 11/43 (26%), P < 0.01) and non-wound infections (
2 (5%) v 9 (21%), P < 0.05).
Conclusions Antibiotic prophylaxis with a single dose of co-amoxiclav signi
ficantly reduces the risk of infectious complications after percutaneous en
doscopic gastrostomy and should be recommended.