BACKGROUND: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is a technique frequently used to diagnose solid and cystic lesions of the pancreas. Antibiotic prophylaxis has been recommended for EUS-FNA of pancreatic cystic lesions but is not universally observed. The most effective antibiotic and the most efficacious route and regimen of administration are also unknown. OBJECTIVE: This cohort study was undertaken to evaluate whether single-dose piperacillin/tazobactam or ciprofloxacin given at the time of the procedure effectively prevents major adverse events and to audit the adherence to this protocol in the setting of EUS-FNA of pancreatic cystic lesions. DESIGN: Consecutive EUS-FNA procedures of pancreatic cystic lesions were performed at Concord Hospital and significant variables regarding the procedure and adverse events were recorded. Patients were also contacted by telephone to follow-up any subacute adverse events they may have experienced. PATIENTS: Over a 30 month period (January 2010-July 2012), a total of 85 EUS-FNAs of pancreatic cysts were performed on 80 different patients. The mean age was 63.2 years (range 17-89 years; 58% females). INTERVENTIONS: Single-dose piperacillin/tazobactam IVs was administered to 87% of patients, while 12% of patients received ciprofloxacin IVs. RESULTS: No patients developed cyst infection, fever, or sepsis (0%) and one patient (1.2%) was hospitalised for self-limited nausea without adverse sequelae. CONCLUSIONS: Single-dose piperacillin/tazobactam at the time of EUS-FNA of pancreatic cysts is an effective prophylaxis of cyst infection or sepsis and can be conveniently given as a single-dose peri-procedurally without further oral antibiotics.
BACKGROUND: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is a technique frequently used to diagnose solid and cystic lesions of the pancreas. Antibiotic prophylaxis has been recommended for EUS-FNA of pancreatic cystic lesions but is not universally observed. The most effective antibiotic and the most efficacious route and regimen of administration are also unknown. OBJECTIVE: This cohort study was undertaken to evaluate whether single-dose piperacillin/tazobactam or ciprofloxacin given at the time of the procedure effectively prevents major adverse events and to audit the adherence to this protocol in the setting of EUS-FNA of pancreatic cystic lesions. DESIGN: Consecutive EUS-FNA procedures of pancreatic cystic lesions were performed at Concord Hospital and significant variables regarding the procedure and adverse events were recorded. Patients were also contacted by telephone to follow-up any subacute adverse events they may have experienced. PATIENTS: Over a 30 month period (January 2010-July 2012), a total of 85 EUS-FNAs of pancreatic cysts were performed on 80 different patients. The mean age was 63.2 years (range 17-89 years; 58% females). INTERVENTIONS: Single-dose piperacillin/tazobactam IVs was administered to 87% of patients, while 12% of patients received ciprofloxacin IVs. RESULTS: No patients developed cyst infection, fever, or sepsis (0%) and one patient (1.2%) was hospitalised for self-limited nausea without adverse sequelae. CONCLUSIONS: Single-dose piperacillin/tazobactam at the time of EUS-FNA of pancreatic cysts is an effective prophylaxis of cyst infection or sepsis and can be conveniently given as a single-dose peri-procedurally without further oral antibiotics.
Authors: Dayna S Early; Ruben D Acosta; Vinay Chandrasekhara; Krishnavel V Chathadi; G Anton Decker; John A Evans; Robert D Fanelli; Deborah A Fisher; Lisa Fonkalsrud; Joo Ha Hwang; Terry L Jue; Mouen A Khashab; Jenifer R Lightdale; V Raman Muthusamy; Shabana F Pasha; John R Saltzman; Ravi N Sharaf; Amandep K Shergill; Brooks D Cash Journal: Gastrointest Endosc Date: 2013-06 Impact factor: 9.427
Authors: Carlos Guarner-Argente; Pari Shah; Anna Buchner; Nuzhat A Ahmad; Michael L Kochman; Gregory G Ginsberg Journal: Gastrointest Endosc Date: 2011-07 Impact factor: 9.427
Authors: Nan Ge; William R Brugge; Payal Saxena; Anand Sahai; Douglas G Adler; Marc Giovannini; Nonthalee Pausawasdi; Erwin Santo; Girish Mishra; William Tam; Mitsuhiro Kida; Jose G de la Mora-Levy; Malay Sharma; Muhammad Umar; Akio Katanuma; Linda Lee; Pramod Kumar Garg; Mohamad Ali Eloubeidi; Ho Khek Yu; Isaac Raijman; Brenda Lucia Arturo Arias; Manoop Bhutani; Silvia Carrara; Praveer Rai; Shuntaro Mukai; Laurent Palazzo; Christoph F Dietrich; Nam Q Nguyen; Mohamed El-Nady; Jan Werner Poley; Simone Guaraldi; Evangelos Kalaitzakis; Luis Carlos Sabbagh; Jose Lariño-Noia; Frank G Gress; Yuk-Tong Lee; Surinder S Rana; Pietro Fusaroli; Michael Hocke; Vinay Dhir; Sundeep Lakhtakia; Thawee Ratanachu-Ek; A S Chalapathi Rao; Peter Vilmann; Hussein Hassan Okasha; Atsushi Irisawa; Ryan Ponnudurai; Ang Tiing Leong; Everson Artifon; Julio Iglesias-Garcia; Adrian Saftoiu; Alberto Larghi; Carlos Robles-Medranda; Siyu Sun Journal: Endosc Ultrasound Date: 2019 Nov-Dec Impact factor: 5.628