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Published on: September 21, 2015

Antibiotic prophylaxis tailored to local organisms reduces percutaneous gastrostomy site infection

S Mahadeva1, I-C Sam, B-L Khoo

  • 1Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. sanjiv@ummc.edu.my

International Journal of Clinical Practice
|February 19, 2009
PubMed
Abstract

Insights

Tailoring antibiotic prophylaxis for percutaneous endoscopic gastrostomy (PEG) insertion to local infection patterns significantly reduces PEG-wound infections and their severity. This approach improves patient outcomes by lowering complication rates.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Surgical Prophylaxis

Background:

  • Current antibiotic prophylaxis guidelines for percutaneous endoscopic gastrostomy (PEG) may not be universally effective.
  • Local microbial resistance patterns can impact the success of standard prophylactic regimens.

Purpose of the Study:

  • To review the microbiology of PEG-wound infections at a specific institution.
  • To evaluate the impact of a revised antibiotic prophylaxis policy on PEG infection rates.

Main Methods:

  • Retrospective analysis of PEG-wound infections and microbiology data.
  • Implementation of a new antibiotic prophylaxis regimen (cefoperazone).
  • Follow-up review of infection rates and outcomes after the policy change.

Main Results:

  • Initial prophylaxis (cephalosporins/co-amoxiclav) was associated with a 32.0% PEG-wound infection rate, with common pathogens including Pseudomonas aeruginosa and MRSA.
  • High resistance rates (over 50%) were observed for cefuroxime and co-amoxiclav.
  • Changing prophylaxis to cefoperazone reduced infection rates to 18.9% (p=0.04), decreased P. aeruginosa infections, and lowered rates of pyrexia and PEG removal.

Conclusions:

  • Antibiotic prophylaxis for PEG insertion should be customized based on local microbiological data.
  • Tailored prophylaxis effectively reduces the incidence and severity of peri-stomal infections.
  • This strategy optimizes patient outcomes following PEG procedures.

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