Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts?
Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound–guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2022-11-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2021-150.pdf |
| _version_ | 1827609457589223424 |
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| author | Seifeldin Hakim Mihajlo Gjeorgjievski Zubair Khan Michael E. Cannon Kevin Yu Prithvi Patil Roy Tomas DaVee Sushovan Guha Ricardo Badillo Laith Jamil Nirav Thosani Srinivas Ramireddy |
| author_facet | Seifeldin Hakim Mihajlo Gjeorgjievski Zubair Khan Michael E. Cannon Kevin Yu Prithvi Patil Roy Tomas DaVee Sushovan Guha Ricardo Badillo Laith Jamil Nirav Thosani Srinivas Ramireddy |
| author_sort | Seifeldin Hakim |
| collection | DOAJ |
| description | Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound–guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB– group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit. |
| first_indexed | 2024-03-09T07:32:41Z |
| format | Article |
| id | doaj.art-d2dc4552a76949aeb2f3624c53774768 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T07:32:41Z |
| publishDate | 2022-11-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-d2dc4552a76949aeb2f3624c537747682023-12-03T05:55:06ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-11-0155680180910.5946/ce.2021.1507670Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts?Seifeldin Hakim0Mihajlo Gjeorgjievski1Zubair Khan2Michael E. Cannon3Kevin Yu4Prithvi Patil5Roy Tomas DaVee6Sushovan Guha7Ricardo Badillo8Laith Jamil9Nirav Thosani10Srinivas Ramireddy11 Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Division of Gastroenterology and Hepatology, Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Division of Gastroenterology and Hepatology, Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Department of Internal Medicine, The University of Texas Health Science Center, Houston, TX, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Division of Gastroenterology and Hepatology, Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USA Center for Interventional Gastroenterology at UTHealth (iGUT), McGovern Medical School at UTHealth, Houston, TX, USABackground/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound–guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB– group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.http://www.e-ce.org/upload/pdf/ce-2021-150.pdfantibiotic prophylaxisendosonographyfine needle aspirationpancreatic cyst |
| spellingShingle | Seifeldin Hakim Mihajlo Gjeorgjievski Zubair Khan Michael E. Cannon Kevin Yu Prithvi Patil Roy Tomas DaVee Sushovan Guha Ricardo Badillo Laith Jamil Nirav Thosani Srinivas Ramireddy Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts? Clinical Endoscopy antibiotic prophylaxis endosonography fine needle aspiration pancreatic cyst |
| title | Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts? |
| title_full | Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts? |
| title_fullStr | Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts? |
| title_full_unstemmed | Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts? |
| title_short | Is antibiotic prophylaxis necessary after endoscopic ultrasound–guided fine-needle aspiration of pancreatic cysts? |
| title_sort | is antibiotic prophylaxis necessary after endoscopic ultrasound guided fine needle aspiration of pancreatic cysts |
| topic | antibiotic prophylaxis endosonography fine needle aspiration pancreatic cyst |
| url | http://www.e-ce.org/upload/pdf/ce-2021-150.pdf |
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