A single dose of ceftriaxone administered 30 minutes before percutaneous endoscopic gastrostomy significantly reduces local and systemic infective complications

OBJECTIVE: The aim of this study was to determine the efficacy of antibioti c prophylaxis in percutaneous endoscopic gastrostomy (PEG). METHODS: An open prospective. randomised, multicenter study was conducted i n 141 patients; 72 received ceftriaxone 1 g i.v. 30 min preintervention, an d 69 received no study medication. A standardized protocol was followed for PEG preparation, insertion, and aftercare; all patients received a IS-Fr g astrostomy tube. Follow-up of local and systemic infection and clinical cou rse was continued to postintervention day 10. An aggregate erythema and exu dation score >3 or thr presence of pus was taken as indicative of peristoma l 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, I versus 10.1% (p 0.03) and 14.5% (p = 0.10), respec tively, in prophylaxis patients. Results were disproportionally better in t umor patients: systemic infection rates were 16.7% versus 5.8% in no-prophy laxis versus prophylaxis patients (p = 0.045, and overall infection rates 3 8.9% versus 17.4%, respectively (p = 0.046). Pneumonia was more frequent in patients with underlying neurological disease. Antibiotic costs were the s ame in both groups (p = 0.792). CONCLUSIONS: Single dose ceftriaxone 1 g is an effective prophylaxis agains t local and systemic infection after PEG. (C) 1999 by Am. Cell. of Gastroen terology.