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Published on: January 27, 2019
Antibiotic prophylaxis for percutaneous endoscopic gastrostomy in pediatric patients: a meta-analysis
Thiago M A Veiga1, Pedro E P Carvalho1, Felipe S L Machado1
1Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Insights
Antibiotic prophylaxis (AP) effectively reduced systemic infections in pediatric patients undergoing Percutaneous Endoscopic Gastrostomy (PEG). However, AP did not significantly impact wound infections or overall infection rates in this patient group.
Area of Science:
- Pediatric Gastroenterology
- Infectious Disease Prevention
- Surgical Site Infection Research
Background:
- Percutaneous Endoscopic Gastrostomy (PEG) is a common procedure in pediatric patients.
- Infection is a potential complication following PEG placement.
- The role of antibiotic prophylaxis (AP) in preventing these infections requires clarification.
Approach:
- A systematic search of PubMed, Embase, and Cochrane databases was conducted.
- Included studies were Randomized Controlled Trials (RCTs) and Observational Studies comparing AP versus no intervention (NI).
- Pooled analysis using random-effect models was performed to determine the odds ratio (OR) and 95% confidence intervals (CI).
Key Points:
- The analysis included four studies with 568 pediatric patients undergoing PEG.
- Antibiotic prophylaxis (AP) significantly reduced the incidence of systemic infections (OR 0.46; 95% CI 0.24-0.90; p=0.02).
- No statistically significant difference was observed for wound infection (OR 0.85; 95% CI 0.43-1.69) or the composite outcome of any infection (OR 0.74; 95% CI 0.13-4.06).
Conclusions:
- Antibiotic prophylaxis (AP) is effective in preventing systemic infections in pediatric patients following PEG.
- AP did not demonstrate a significant benefit in preventing wound infections or the combined endpoint of any infection.
- Findings align with those observed in adult populations, suggesting a consistent effect of AP on systemic infection risk post-PEG.
Purpose:
To investigate if Antibiotic Prophylaxis (AP) can prevent wound and/or systemic infection in pediatric patients who underwent Percutaneous Endoscopic Gastrostomy (PEG).
Methods:
PubMed, Embase, and Cochrane databases were searched for Randomized Controlled Trials (RCT) and Observational Studies that compared AP vs. no Intervention (NI) in children submitted to PEG. Odds ratios (OR) with 95% confidence intervals (CI) were pooled with random-effect models. Quality assessment and risk of bias were performed as outlined by Cochrane recommendations.
Results:
Four studies, including one RCT, with a total of 568 patients were included, in which 230 (40.5%) individuals received AP. The use of AP during PEG reduced the incidence of systemic infection (OR 0.46; 95% CI 0.24-0.90; p = 0.02; I2 = 0). However, no statistical difference was found for wound infection (OR 0.85; 95% CI 0.43-1.69; p = 0.64; I2 = 12%) and for the composite outcome of any kind of infection (OR 0.74; 95% CI 0.13-4.06; p = 0.73; I2 = 67%).
Conclusion:
In this pooled analysis of 568 infants who underwent PEG, the use of AP reduced the incidence of systemic infection. Our results were compatible with findings obtained in the adult population. No differences were found regarding wound infection or the composite outcome of any kind of infection.
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