OBJECTIVES: The role of prophylactic antibiotherapy prior to elective endoscopic retrograde cholangiopancreatography (ERCP) is unclear. We aimed to determine whether patients receiving systemic antibiotics prior to ERCP had lower morbidity and mortality rates as well as shorter hospitalization compared to patients who did not receive antibiotic prophylaxis. MATERIALS AND METHODS: We conducted a prospective study of all patients undergoing ERCP in our unit. Antibiotic use, postERCP cholangitis rates, 30-day mortality and hospital stay were studied. Also, bacteriological examination of bile aspirates from these patients was conducted and antibiotic susceptibility was determined for the isolated pathogens. OUTCOMES: One hundred-thirty eight consecutive ERCPs conducted in our unit in a 9 month period were included. Cholangitis developed in 3 (4.6%) cases in the antibiotics groups and 3 (4%) cases in the control group (p=0.8). Hospital stay did not differ significantly between the two study groups (p=0.58). There was only one procedure-related death which was the result of postERCP pancreatitis in a patient with severe associated illnesses. Bile aspirates showed bacterial growth in 75% of the cases where bile was obtained, with E. coli being the most frequently isolated microorganism. No differences in bacteriological profiles were noted between the two study groups. CONCLUSION: There seems to be no influence on patient-related outcome of antibiotic prophylaxis prior to elective ERCP.
OBJECTIVES: The role of prophylactic antibiotherapy prior to elective endoscopic retrograde cholangiopancreatography (ERCP) is unclear. We aimed to determine whether patients receiving systemic antibiotics prior to ERCP had lower morbidity and mortality rates as well as shorter hospitalization compared to patients who did not receive antibiotic prophylaxis. MATERIALS AND METHODS: We conducted a prospective study of all patients undergoing ERCP in our unit. Antibiotic use, postERCP cholangitis rates, 30-day mortality and hospital stay were studied. Also, bacteriological examination of bile aspirates from these patients was conducted and antibiotic susceptibility was determined for the isolated pathogens. OUTCOMES: One hundred-thirty eight consecutive ERCPs conducted in our unit in a 9 month period were included. Cholangitis developed in 3 (4.6%) cases in the antibiotics groups and 3 (4%) cases in the control group (p=0.8). Hospital stay did not differ significantly between the two study groups (p=0.58). There was only one procedure-related death which was the result of postERCP pancreatitis in a patient with severe associated illnesses. Bile aspirates showed bacterial growth in 75% of the cases where bile was obtained, with E. coli being the most frequently isolated microorganism. No differences in bacteriological profiles were noted between the two study groups. CONCLUSION: There seems to be no influence on patient-related outcome of antibiotic prophylaxis prior to elective ERCP.
Authors: Subhas Banerjee; Bo Shen; Todd H Baron; Douglas B Nelson; Michelle A Anderson; Brooks D Cash; Jason A Dominitz; S Ian Gan; M Edwyn Harrison; Steven O Ikenberry; Sanjay B Jagannath; David Lichtenstein; Robert D Fanelli; Ken Lee; Trina van Guilder; Leslie E Stewart Journal: Gastrointest Endosc Date: 2008-03-28 Impact factor: 9.427
Authors: S J van den Hazel; P Speelman; J Dankert; K Huibregtse; G N Tytgat; D J van Leeuwen Journal: Ann Intern Med Date: 1996-09-15 Impact factor: 25.391
Authors: E J Williams; S Taylor; P Fairclough; A Hamlyn; R F Logan; D Martin; S A Riley; P Veitch; M L Wilkinson; P R Williamson; M Lombard Journal: Endoscopy Date: 2007-09 Impact factor: 10.093