Plastic stents are the mainstay of the palliation of malignant jaundice but are complicated by recurrent obstruction.
Previous trials have failed to demonstrate any improvement in patency with the use of antibiotics.
Dr Barkun and colleagues randomized patients with malignant jaundice, after polyethylene stent insertion, to receive ciprofloxacin or placebo in a double-blind fashion.
The investigators included, after successful stent decompression, 50 patients in the treatment arm and 44 in the placebo.
Episodes of cholangitis with ciprofloxacin were 23% versus 42% with the placebo |
|Journal of Gastrointestinal Surgery|
There were 33% of episodes of stent occlusion in the ciprofloxacin group versus 49% in placebo.
The researchers observed no significant difference in patency.
There were significantly fewer episodes of cholangitis with ciprofloxacin with 23% versus 42% in the placebo group.
The research team also demonstrated that the ciprofloxacin group also significantly improved the Social Function domain of the Social Funciton-36 Quality of Life Survey at 1 month.
The team noted that the other domains of the Social Function-36 were not different, nor was survival.
Dr Barkun concludes, “ There is insufficient evidence to show that prophylactic ciprofloxacin can prolong plastic biliary stent patency.”
“The observed trends suggest that ciprofloxacin significantly decreases the incidence of cholangitis and results in improvements in certain aspects of quality of life.”