Despite numerous guidelines recommending prophylactic antibiotics prior to percutaneous endoscopic gastrostomy, their use remains controversial.
Dr Galandiuk and colleagues from Louisville determined the benefit of antibiotic prophylaxis for percutaneous endoscopic gastrostomy placement.
The research team performed a systematic literature review of healthcare databases and grey literature, and performed a meta-analysis.
The team searched for randomized-controlled trials of antibiotic prophylaxis against wound infection after percutaneous endoscopic gastrostomy.
Relative risks were calculated for individual trials and data pooled using fixed-effects model.
|The number needed to treat was 8|
|Alimentary Pharmacology & Therapeutics|
Relative risk reduction, absolute risk reduction and number needed to treat were calculated and are reported with 95% confidence intervals.
The researchers found 10 randomized-controlled trials that met the inclusion criteria, and 1059 cases were pooled.
The team observed that antibiotic prophylaxis resulted in a relative risk reduction of 64%, and an absolute risk reduction of 15%.
The researchers noted that the number needed to treat to prevent 1 wound infection was 8.
Cephalosporin prophylaxis was associated with a relative risk reduction of 64%, absolute risk reduction of 10%, and number needed to treat of 10.
The team found that penicillin-based prophylaxis was associated with a relative risk reduction of 62%.
The absolute risk reduction of penicillin-based prophylaxis was 13%, and the number needed to treat was 8.
Dr Galandiuk's team concludes, “Antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy is effective in reducing the incidence of percutaneous endoscopic gastrostomy site wound infection.”
“Based on sensitivity analyses, penicillin-based prophylaxis should be the prophylaxis of choice.”