Perioperative antibiotics should be used for placement of implanted central venous ports: A propensity analysis evaluating risk.
Am J Surg 2018;
216:1135-1143. [PMID:
30268417 DOI:
10.1016/j.amjsurg.2018.09.022]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 08/21/2018] [Accepted: 09/16/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE
To quantify risk for CRI based on PABX use in CVAP placement for cancer patients.
SUMMARY BACKGROUND DATA
Central venous access ports (CVAP) are totally implanted devices used for chemotherapy. There is a temporal risk for catheter related infection (CRI) to insertion and perioperative prophylactic antibiotics (PABX) use is a contested issue among practitioners.
METHODS
Data was collected from a single center, academic oncology center. Treatment with a perioperative PABX was compared to non-treatment, to examine the incidence of 14-day CRI. Propensity scores with matched weights controlled for confounding, using 15 demographic, procedural and clinical variables.
RESULTS
From 2007 to 2012, 1,091 CVAP were placed, where 59.7 % received PABX. The 14-day CRI rate was 0.82%, with 78% of those not receiving PABX. While results did not achieve statistical significance, use of PABX was associated with a 58% reduction in the odds of a 14-day CRI (OR = 0.42, 95% CI: 0.08-2.24, p = 0.31).
CONCLUSION
The findings suggest a reduction in early CRI with the use of PABX. Since CRI treatment can range from a course of oral antibiotics, port removal, to hospital admission, we suggest clinicians consider these data when considering PABX in this high-risk population.
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