title: Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG)--results from a prospective randomized multicenter trial.
abstract: OBJECTIVE
  To determine the efficacy of antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG) as a part of a standardized regimen.
  
  
  METHODS
  An open prospective randomised multicenter study in 216 patients. 106 received ceftriaxone 1 g i.v. 30 min preinterventionally and 110 no study medication. A standardized protocol was followed for PEG preparation, insertion, and aftercare; all patients received a 15 French gastrostomy tube. Follow-up of local and systemic infection and clinical course was continued to postintervention day 10. An aggregate erythema and exudation score > 3 or the presence of pus was taken as indicative of peristomal infection. The pharmacoeconomics of antibiotic use were also examined.
  
  
  RESULTS
  In no-prophylaxis patients, wound infection rates were 23.6% on day 4 and 24.5% on day 10 vs. 7.6% (p < 0.05) and 11.4% (p < 0.05), respectively, in prophylaxis patients. Results were disproportionally better in tumor patients in comparison with neurological patients. Patients systemic infection rates were 11.8% vs. 1.9% in noprophylaxis vs. prophylaxis (p < 0.05), and overall infection rates 36.3% vs. 13.3%, respectively (p < 0.05). Pneumonia was more frequent in patients with underlying neurological disease and reduced in the prophylaxis group. Antibiotic and application costs were similar in both groups (p = 0.400).
  
  
  CONCLUSIONS
  Single-dose ceftriaxone 1 g is a effective prophylaxis against local and systemic infection after PEG and should be a part of a standard regimen.
authors.affiliation: German PEG Multicenter Trial Group, Medizinische Klinik, Klinikum Minden.
authors.forename: A J
authors.initials: AJ
authors.lastname: Dormann
authors.forename: B
authors.initials: B
authors.lastname: Wigginghaus
authors.forename: H
authors.initials: H
authors.lastname: Risius
authors.forename: F
authors.initials: F
authors.lastname: Kleimann
authors.forename: A
authors.initials: A
authors.lastname: Kloppenborg
authors.forename: J
authors.initials: J
authors.lastname: Rosemann
authors.forename: Y
authors.initials: Y
authors.lastname: Padel
authors.forename: R
authors.initials: R
authors.lastname: Pohl
authors.forename: H H
authors.initials: HH
authors.lastname: Baum
authors.forename: A
authors.initials: A
authors.lastname: Lübbesmeier
authors.forename: J
authors.initials: J
authors.lastname: Schwab
authors.forename: V
authors.initials: V
authors.lastname: Kühlkamp
authors.forename: W
authors.initials: W
authors.lastname: Gutjahr
authors.forename: W
authors.initials: W
authors.lastname: Lindenburger
authors.forename: H
authors.initials: H
authors.lastname: Schütz
authors.forename: H
authors.initials: H
authors.lastname: Huchzermeyer
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000008:administration & dosage*; D003428:Cross Infection / Q000517:prevention & control*; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D002443:Ceftriaxone