Antibiotics Do Not Decrease the Rate of Infection After Endoscopic Ultrasound Fine-Needle Aspiration of Pancreatic Cysts.
Aged
Aged, 80 and over
Antibiotic Prophylaxis
Bacterial Infections
/ diagnosis
Databases, Factual
Endoscopic Ultrasound-Guided Fine Needle Aspiration
/ adverse effects
Female
Humans
Male
Middle Aged
Pancreatic Cyst
/ pathology
Retrospective Studies
Risk Assessment
Risk Factors
Unnecessary Procedures
Endoscopic ultrasound
FNA
Lesion
Pancreas
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
20
03
2019
accepted:
30
04
2019
pubmed:
9
5
2019
medline:
26
2
2020
entrez:
9
5
2019
Statut:
ppublish
Résumé
In spite of the weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions is routinely used in the clinical practice. To compare a group of patients treated with antibiotics before fine-needle aspiration of pancreatic cystic lesions and a group who did not undergo antimicrobial prophylaxis. Out of 335 patients with suspected pancreatic cystic lesions referred to our center between 2006 and 2018, after propensity score matching two groups were compared: 135 subjects who underwent endoscopic ultrasound fine-needle aspiration under antibiotic prophylaxis and 135 treated with no antimicrobial agents. Primary outcome was infection rate; secondary endpoints included other complications or antibiotic-related adverse events. Median age was 64 (interquartile range 61-68) and median cyst size was 24 mm (22-28), with no difference between groups. Overall, 10 adverse events (7.1%) of which 2 serious (1.4%) were observed in the antibiotic group and 8 (5.8%) of which 1 (0.7%) serious in the non-antibiotic group. Cyst infection was observed in 2 patients (1.4%) in the antibiotic group and 3 patients (2.2%) in the other cohort (p = 0.65). Prophylactic antibiotics do not seem to substantially reduce this risk of infection, and their routine use should be abandoned.
Sections du résumé
BACKGROUND
In spite of the weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions is routinely used in the clinical practice.
AIMS
To compare a group of patients treated with antibiotics before fine-needle aspiration of pancreatic cystic lesions and a group who did not undergo antimicrobial prophylaxis.
METHODS
Out of 335 patients with suspected pancreatic cystic lesions referred to our center between 2006 and 2018, after propensity score matching two groups were compared: 135 subjects who underwent endoscopic ultrasound fine-needle aspiration under antibiotic prophylaxis and 135 treated with no antimicrobial agents. Primary outcome was infection rate; secondary endpoints included other complications or antibiotic-related adverse events.
RESULTS
Median age was 64 (interquartile range 61-68) and median cyst size was 24 mm (22-28), with no difference between groups. Overall, 10 adverse events (7.1%) of which 2 serious (1.4%) were observed in the antibiotic group and 8 (5.8%) of which 1 (0.7%) serious in the non-antibiotic group. Cyst infection was observed in 2 patients (1.4%) in the antibiotic group and 3 patients (2.2%) in the other cohort (p = 0.65).
CONCLUSIONS
Prophylactic antibiotics do not seem to substantially reduce this risk of infection, and their routine use should be abandoned.
Identifiants
pubmed: 31065897
doi: 10.1007/s10620-019-05655-x
pii: 10.1007/s10620-019-05655-x
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2308-2315Commentaires et corrections
Type : CommentIn
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