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Impact of Antibiotic Prophylaxis on Infection Rate after Endoscopic Ultrasound Through-the-Needle Biopsy of Pancreatic Cysts: A Propensity Score-Matched Study

Authors :
Antonio Facciorusso
Martha Arevalo-Mora
Maria Cristina Conti Bellocchi
Laura Bernardoni
Daryl Ramai
Paraskevas Gkolfakis
Domenico Loizzi
Nicola Muscatiello
Antonio Ambrosi
Nicola Tartaglia
Carlos Robles-Medranda
Elisa Stasi
Andrew Ofosu
Stefano Francesco Crinò
Source :
Diagnostics, Vol 12, Iss 1, p 211 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Background: Despite weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided through-the-needle biopsy (EUS-TTNB) of pancreatic cystic lesions (PCLs) is routinely used in clinical practice. We aim to compare a group of patients treated with antibiotics before EUS-TTNB of PCLs and a group who did not undergo antimicrobial prophylaxis. Methods: Out of 236 patients with pancreatic cystic lesions referred to two high-volume centers between 2016 and 2021, after propensity score matching, two groups were compared: 98 subjects who underwent EUS-TTNB under antibiotic prophylaxis and 49 subjects without prophylaxis. Results: There was no difference in terms of baseline parameters between groups. Final diagnosis was serous cystadenoma in 36.7% of patients in the group not treated with prophylaxis and in 37.7% of patients in the control group, whereas IPMN and mucinous cystadenoma were diagnosed in 3 (6.1%) and 16 (32.6%) versus 6 (6.1%) and 32 (32.6%) patients in the two groups, respectively (p = 0.23). Overall, the adverse event rate was 6.1% in the group not treated with antibiotic prophylaxis and 5.1% in the control group (p = 0.49). Only a single infectious adverse event occurred in each group (p = 0.48). The diagnostic yields were 89.7% and 90.8% in the two groups (p = 0.7), and the diagnostic accuracy rate was 81.6% in both groups (p = 1.0). Conclusions: Prophylactic antibiotics do not seem to influence the risk of infection, and their routine use should be discouraged.

Details

Language :
English
ISSN :
20754418
Volume :
12
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.7752358d3c34e06944a2fcfe7a8be48
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics12010211