title: Clinical implementation of a new antibiotic prophylaxis regimen for percutaneous endoscopic gastrostomy.
abstract: OBJECTIVE
  This study was undertaken to test the extent to which a new antibiotic prophylaxis regimen for percutaneous endoscopic gastrostomy (PEG), identified as a justified and simpler alternative to conventional regimen in a randomised clinical trial, has been adopted in clinical practice.
  
  
  METHODS
  A Swedish nationwide implementation survey, conducted in February 2013, assessed the level of clinical implementation of a 20 ml dose of oral solution of sulfamethoxazole and trimethoprim deposited in the PEG catheter immediately after insertion. All hospitals inserting at least five PEGs annually were identified from the Swedish Patient Registry. A clinician involved in the PEG insertions at each hospital participated in a structured telephone interview addressing their routine use of antibiotic prophylaxis.
  
  
  METHODS
  All Swedish hospitals inserting PEGs (n=60).
  
  
  METHODS
  Representatives of PEG insertions at each of the 60 eligible hospitals participated (100% participation).
  
  
  METHODS
  Use of routine antibiotic prophylaxis for PEG.
  
  
  RESULTS
  A total of 32 (53%) of the 60 hospitals had adopted the new regimen. It was more frequently adopted in university hospitals (67%) than in community hospitals (41%). An annual total of 1813 (70%) of 2573 patients received the new regimen. Higher annual hospital volume was associated with a higher level of adoption of the new regimen (80% in the highest vs 31% in the lowest).
  
  
  CONCLUSIONS
  The clinical implementation of the new antibiotic prophylaxis regimen for PEG was high and rapid (70% of all patients within 3 years), particularly in large hospitals.
authors.affiliation: Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
authors.forename: Fredrik
authors.initials: F
authors.lastname: Mattsson
authors.forename: Pernilla
authors.initials: P
authors.lastname: Lagergren
keywords: NUTRITION & DIETETICS; SURGERY