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Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomyLipp A, Lusardi G
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SummaryAdministration of intravenous antibiotics before placement of a percutaneous endoscopic gastrostomy (PEG) reduces infection at the site.A percutaneous endoscopic gastrostomy (PEG) is a feeding tube that goes into the stomach (through the belly) of patients who cannot take food by mouth. A surgical procedure is required to put these tubes in place. Antibiotics are often given intravenously before this surgical procedure, as a precaution, to reduce the risk of infection at the site of operation. Eleven research studies were included in this review, and they confirm that those people who were given antibiotics when their PEG was inserted were less likely to suffer an infection at the site.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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October 18. 2006 AbstractBackgroundPercutaneous endoscopic gastrostomies (PEG) maintain nutrition in the short or long term. A PEG is a feeding tube, placed surgically through the anterior abdominal wall, which delivers a liquid diet, or medication, via a clean or sterile delivery system. Those undergoing PEG placement are often vulnerable to infection because of age, compromised nutritional intake, immunosuppression and underlying disease processes such as malignancy and diabetes mellitus. The increasing incidence of methicillin-resistant Staphylococcus aureus (MRSA) contributes both an additional risk to the placement procedure, and also to the debate surrounding antibiotic prophylaxis for PEG placement. The aim of surgical antimicrobial prophylaxis is to establish a bactericidal concentration of an antimicrobial drug in the patients serum and tissues, via a brief course of an appropriate agent, by the time of PEG placement. ObjectivesThe review seeks to establish whether prophylactic use of systemic antimicrobials reduces the risk of peristomal infection in people undergoing placement of percutaneous endoscopic gastrostomies. Search strategyFor the first update we searched the Cochrane Wounds Group Specialised Register (May 2008); The Cochrane Central Register of Controlled Trials (CENTRAL) The Cochrane Library Issue 2 2008; Ovid MEDLINE (2005 to April Week 4 2008); Ovid EMBASE (2005 to Week 17 2008) and Ovid CINAHL (2005 to April Week 4 2008). Selection criteriaRandomised controlled trials (RCTs) evaluating the use of prophylactic antimicrobials for PEG placement, with no restrictions for language, date or publication status. Data collection and analysisBoth authors performed data extraction and assessment of study quality. Meta-analysis was performed where appropriate. Main resultsFor the first update we identified one additional trial bringing the total to 11 eligible RCTs evaluating prophylactic antimicrobials in 1196 patients. All trials reported peristomal infection as an outcome, and a pooled analysis resulted in a statistically significant reduction in the incidence of peristomal infection with prophylactic antibiotics (843 patients pooled OR 0.35, 95% CI 0.23 to 0.48).
Authors' conclusionsAdministration of systemic prophylactic antibiotics for PEG placement reduces peristomal infection. |
