title: Totally implantable venous access device placement by interventional radiologists: are prophylactic antibiotics necessary?
abstract: OBJECTIVE
  To determine the rate of early infection for totally implantable venous access devices (TIVADs) placed without antibiotic prophylaxis.
  
  
  METHODS
  A list of patients who underwent TIVAD placement in 2009 was obtained from the patient archiving and communication system (PACS). This list was cross-referenced to all patients who underwent TIVAD removal from January 1, 2009, through January 30, 2010, to identify TIVADs that were removed within 30 days of placement. Retrospective chart review was performed to record patient demographics, including age, sex, cancer diagnosis, and indication for removal. Concurrent antibiotic therapy, chemotherapy, and laboratory data before and within 30 days of placement were recorded. Central line-associated bloodstream infections (CLABSIs) were identified using U.S. Centers for Disease Control and Prevention (CDC) criteria.
  
  
  RESULTS
  There were 1,183 ports placed and 13 removed. CLABSIs occurred in seven (0.6%) patients within 30 days of placement. At the time of TIVAD placement, 81 (7%) patients were receiving antibiotics incidental to the procedure. One patient who received an antibiotic the day of implantation developed a CLABSI. Chemotherapy was administered to 148 (13%) patients on the day of placement.
  
  
  CONCLUSIONS
  The rate of early infection without antibiotic prophylaxis before TIVAD placement in the interventional radiology suite is < 1%. Based on these data, use of prophylactic antibiotics for TIVAD placement is not recommended.
authors.affiliation: Department of Diagnostic Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. coveya@mskcc.org
authors.forename: Anne M
authors.initials: AM
authors.lastname: Covey
authors.forename: Franz W
authors.initials: FW
authors.lastname: Toro-Pape
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Thornton
authors.forename: Crystal
authors.initials: C
authors.lastname: Son
authors.forename: Joseph
authors.initials: J
authors.lastname: Erinjeri
authors.forename: Constantinos T
authors.initials: CT
authors.lastname: Sofocleous
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Brody
authors.forename: Karen T
authors.initials: KT
authors.lastname: Brown
authors.forename: Kent A
authors.initials: KA
authors.lastname: Sepkowitz
authors.forename: Kent A
authors.initials: KA
authors.lastname: Septkowitz
authors.forename: George I
authors.initials: GI
authors.lastname: Getrajdman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult