title: Antibiotic Prophylaxis Prior to Elective ERCP Does Not Alter Cholangitis Rates or Shorten Hospital Stay: Results of an Observational Prospective Study of 138 Consecutive ERCPS.
abstract: OBJECTIVE
  The role of prophylactic antibiotherapy prior to elective endoscopic retrograde cholangiopancreatography (ERCP) is unclear. We aimed to determine whether patients receiving systemic antibiotics prior to ERCP had lower morbidity and mortality rates as well as shorter hospitalization compared to patients who did not receive antibiotic prophylaxis.
  
  
  METHODS
  We conducted a prospective study of all patients undergoing ERCP in our unit. Antibiotic use, postERCP cholangitis rates, 30-day mortality and hospital stay were studied. Also, bacteriological examination of bile aspirates from these patients was conducted and antibiotic susceptibility was determined for the isolated pathogens.
  
  
  RESULTS
  One hundred-thirty eight consecutive ERCPs conducted in our unit in a 9 month period were included. Cholangitis developed in 3 (4.6%) cases in the antibiotics groups and 3 (4%) cases in the control group (p=0.8). Hospital stay did not differ significantly between the two study groups (p=0.58). There was only one procedure-related death which was the result of postERCP pancreatitis in a patient with severe associated illnesses. Bile aspirates showed bacterial growth in 75% of the cases where bile was obtained, with E. coli being the most frequently isolated microorganism. No differences in bacteriological profiles were noted between the two study groups.
  
  
  CONCLUSIONS
  There seems to be no influence on patient-related outcome of antibiotic prophylaxis prior to elective ERCP.
authors.affiliation: Colentina Hospital, Bucharest, Romania ; "Carol Davila" School of Medicine, Bucharest, Romania.
authors.forename: Theodor Alexandru
authors.initials: TA
authors.lastname: Voiosu
authors.affiliation: Colentina Hospital, Bucharest, Romania.
authors.forename: Andreea
authors.initials: A
authors.lastname: Bengus
authors.affiliation: Colentina Hospital, Bucharest, Romania.
authors.forename: Andrei
authors.initials: A
authors.lastname: Haidar
authors.affiliation: Colentina Hospital, Bucharest, Romania ; "Carol Davila" School of Medicine, Bucharest, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Rimbas
authors.affiliation: Colentina Hospital, Bucharest, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Zlate
authors.affiliation: Colentina Hospital, Bucharest, Romania ; "Carol Davila" School of Medicine, Bucharest, Romania.
authors.forename: Paul
authors.initials: P
authors.lastname: Balanescu
authors.affiliation: Colentina Hospital, Bucharest, Romania ; "Carol Davila" School of Medicine, Bucharest, Romania.
authors.forename: Andrei
authors.initials: A
authors.lastname: Voiosu
authors.affiliation: Colentina Hospital, Bucharest, Romania ; "Carol Davila" School of Medicine, Bucharest, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Voiosu
authors.affiliation: Colentina Hospital, Bucharest, Romania ; "Carol Davila" School of Medicine, Bucharest, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Mateescu
keywords: ERCP; acute cholangitis; antibiotic prophylaxis; hospital stay