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Do Antibiotics Reduce the Incidence of Infections After Percutaneous Endoscopic Gastrostomy Placement in Children?
Hilde Krom1, Charlotte M W van den Hoek2, Marc A Benninga1
1Pediatric Gastroenterology.
Insights
Prophylactic antibiotic treatment (ABT) for percutaneous endoscopic gastrostomy (PEG) in children did not reduce wound infections. However, ABT may decrease fever, leakage, and hospital stays, though it increased overgranulation.
Area of Science:
- Pediatric Gastroenterology
- Infectious Disease Management
- Surgical Complication Prevention
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a key intervention for long-term enteral feeding in pediatric patients.
- Current pediatric guidelines for PEG placement often recommend prophylactic antibiotic treatment (ABT), largely based on adult data.
Purpose of the Study:
- To evaluate the efficacy of prophylactic antibiotic treatment (ABT) in reducing wound infections and other complications following percutaneous endoscopic gastrostomy (PEG) in children.
- To compare outcomes between pediatric patients who received prophylactic ABT and those who did not.
Main Methods:
- A retrospective study analyzed data from 297 pediatric patients (0-18 years) who underwent PEG placement.
- Patients were divided into groups based on the administration of prophylactic ABT (2010-2013) versus no ABT (2000-2010).
- Outcomes assessed included wound infection, fever, leakage, overgranulation, and hospital admission duration.
Main Results:
- Prophylactic ABT did not significantly alter the wound infection rate (17.9% vs. 21%, P=0.625).
- Patients receiving ABT showed significantly less fever (3.8% vs. 14.6%, P=0.013) and leakage (0% vs. 9.1%, P=0.003), with shorter hospital stays (2 vs. 4 days, P=0.000).
- However, the ABT group experienced more overgranulation (28.2% vs. 8.7%, P=0.000).
Conclusions:
- Prophylactic ABT for pediatric PEG placement does not appear to decrease wound infection rates.
- ABT may offer benefits regarding fever, leakage, and reduced hospital admission duration, but is associated with increased overgranulation.
- Further confirmation through a randomized controlled trial is warranted to validate these findings.
Objective:
Percutaneous endoscopic gastrostomy (PEG) provides a long-term solution for tube dependency. Pediatric guidelines recommend prophylactic antibiotic treatment (ABT) based on adult studies.
Aim:
To compare wound infection and other complications in children receiving a PEG with and without prophylactic ABT.
Methods:
Retrospective study including children 0 to 18 years undergoing PEG placement. Patients with (2010-2013) and without (2000-2010) ABT were compared with respect to the occurrence of wound infection and other complications.
Results:
In total, 297 patients were included (median age 2.9 years, 53% boys). Patients receiving ABT per PEG protocol (n = 78) had a similar wound infection rate (17.9% vs 21%, P = 0.625), significantly less fever (3.8% vs 14.6%, P = 0.013), leakage (0% vs 9.1%, P = 0.003) and shorter hospital admission (2 vs 4 days, P = 0.000), but more overgranulation (28.2% vs 8.7%, P = 0.000) compared with those without (n = 219). Patients receiving any ABT, per PEG protocol or clinical indication (n = 115), had similar occurrence of wound infection (19.1% vs 20.9%, P = 0.768), fever (7.8% vs 14.3%, P = 0.100) and leakage (3.5% vs 8.8%, P = 0.096), a significantly shorter hospital admission (3 vs 4 days, P = 0.000), but more overgranulation (21.7% vs 8.8%, P =0.003) compared with those without (n = 182).
Conclusions:
Prophylactic ABT does not seem to reduce the occurrence of wound infection but it might be beneficial with respect to fever, leakage and duration of hospital admission, but not overgranulation. A randomized controlled trial is needed to confirm our results.
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