Evaluation of antibiotic use to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis and cholangitis.
OBJECTIVE
The purpose of this study was to evaluate the relationship between prophylactic antibiotic use and complications following endoscopic retrograde cholangiopancreatography (ERCP).


METHODS
We retrospectively evaluated 605 consecutive patients who underwent ERCP in our hospital between September 2009 and November 2011. The antibiotic group included patients who underwent their procedure before October 2010, while the control group included patients after October 1, 2010, who did not receive antibiotics. We compared the incidence of postoperative pancreatitis and cholangitis between the groups.


RESULTS
There were no significant differences in the backgrounds of the 304 control and the 301 antibiotic-treated patients. The incidence of post-ERCP pancreatitis was 4.9% in the control group and 4.3% in the antibiotic group (p = 0.72). The incidence of postoperative cholangitis was 2.0% in the control group and 1.7% in the antibiotic group (p = 0.99). Choledocholithiasis, pancreatic duct injection, and female gender were detected as significant risk factors for postoperative pancreatitis by multivariate analysis; sclerosing cholangitis and incomplete biliary drainage were significant risk factors for postoperative cholangitis. Even in cases with these risk factors, prophylactic antibiotic use did not influence the incidence of pancreatitis or cholangitis.


CONCLUSIONS
Prophylactic antibiotics do not reduce the incidence of either pancreatitis or cholangitis following ERCP.
Takashi
T
Ishigaki
Tamito
T
Sasaki
Masahiro
M
Serikawa
Kenso
K
Kobayashi
Michihiro
M
Kamigaki
Tomoyuki
T
Minami
Akihito
A
Okazaki
Masanobu
M
Yukutake
Yasutaka
Y
Ishii
Keiichi
K
Kosaka
Teruo
T
Mouri
Satoshi
S
Yoshimi
Kazuaki
K
Chayama
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002761:Cholangitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents