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DOI: 10.1055/s-0042-1744580
IMPACT OF ANTIBIOTIC PROPHYLAXIS ON INFECTION RATE AFTER ENDOSCOPIC ULTRASOUND THROUGH-THE-NEEDLE BIOPSY OF PANCREATICCYSTS: A PROPENSITY SCORE MATCHED STUDY
Aims Despite the weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided through-the-needle biopsy (EUS-TTNB) of pancreatic cystic lesions (PCLs) is routinely used in the clinical practice. We aim to compare a group of patients treated with antibiotics before EUS-TTNB of PCLs and a group who did not undergo antimicrobial prophylaxis.
Methods Out of 136 patients with pancreatic cystic lesions referred to two high-volume centers between 2016 and 2021, after propensity score matching two groups were compared: 38 subjects who underwent EUS-TTNB under antibiotic prophylaxis and 19 subjects without prophylaxis.
Results There was no difference in terms of baseline parameters between groups. Final diagnosis was serous cystadenoma in 37.1% of patients in the group not treated with prophylaxis and in 49.8% of patients in the control group, whereas IPMN and mucinous cystadenoma were diagnosed in 1 (5.1%) and 6 (32%) versus 1 (2.6%) and 14 (37.2%) patients in the two groups, respectively (p=0.46). Only one case of peri-pancreatic fluid collection treated with EUS-guided drainage was observed in the group not treated with antibiotic prophylaxis (5.2%) whereas a single case (2.6%) of mild abdominal pain managed conservatively was detected in the control group (p=0.61). Diagnostic yield and accuracy rates were 89.4% and 78.9% in both groups, respectively (p=0.9 and 0.85).
Conclusions Prophylactic antibiotics do not seem to influence the risk of infection and their routine use should be discouraged
Publication History
Article published online:
14 April 2022
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