Antibiotic prophylaxis in percutaneous endoscopic gastrostomy

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Prophylaxis

Background:

• Pericutanous endoscopic gastrostomy (PEG) is a common procedure.
• Peristomal infection is a potential complication of PEG.
• The role of prophylactic antibiotics in PEG is debated.

Purpose of the Study:

• To evaluate the efficacy of single-dose Cefazolin prophylaxis in preventing peristomal infections following PEG.
• To compare infection rates between Cefazolin and placebo groups.
• To assess the impact of prior antibiotic use on peristomal infection rates.

Main Methods:

• A prospective, randomized, double-blind, placebo-controlled trial was conducted.
• 115 patients undergoing PEG were enrolled.
• Peristomal infection was assessed daily for one week using a standardized scoring system for erythema, exudate, and induration.

Main Results:

• No significant difference in peristomal infection rates was observed between the Cefazolin group (13%) and the placebo group (19%) (p > 0.5).
• Patients receiving antibiotics for prior medical indications had a significantly lower incidence of wound infection (3%) compared to the placebo group (p < 0.02).

Conclusions:

• A single prophylactic dose of Cefazolin is not effective in reducing peristomal infections after PEG.
• Patients with prior extended antibiotic therapy demonstrate a reduced risk of peristomal wound infections.