Korean J Gastrointest Endosc.  1999 Dec;19(6):925-929.

Antibiotic Prophylaxis in Endoscopic Retrograde Cholangiopancreatography

• Kim CS
• Lee KT
• Lee JK
• Shim SG
• Choi MS
• Sung IK
• Rhee PL
• Kim JJ
• Koh KC
• Paik SW
• Rhee JC
• Choi KW

Abstract

BACKGROUND AND AIMS
Prophylactic antibiotics are used in an attempt to avoid the septic complications of endoscopic retrograde cholangiopancreatography (ERCP). But, there is individual tendency to choose prophylactic antibiotics due to a lack of definite guidelines for prophylactic antibiotics. Therefore, the effectiveness of ciprofloxacin to prevent post ERCP infectious complications was evaluated.
METHODS
One hundred patients underwent 75 diagnostic ERCPs and 25, therapeutic ERCPs. They were classified randomly into a group of 51 prophylaxis (ciprofloxacin 200 mg i.v. 30 min before the procedure) and 49 controls. Pre- and post-ERCP blood cultures were prospectively performed and surveyed for infectious complications.
RESULTS
Sepsis was detected in 4 patients in each group (p>0.05). Two cases were related to diagnostic ERCP and the remaining six cases, therapeutic ERCP (p<0.01). Bacteremia was found in 6 cases, but only two cases (Escherichia coli, Citrobacter freundii) were clinically significant.
CONCLUSIONS
The frequency of sepsis following ERCP was not significantly reduced by antibiotic prophylaxis (7.8% vs. 8.2%).

Keyword

Antibiotic prophylaxis; Endoscopic retrograde cholangiopancreatography

MeSH Terms

Anti-Bacterial Agents
Antibiotic Prophylaxis*
Bacteremia
Cholangiopancreatography, Endoscopic Retrograde*
Ciprofloxacin
Citrobacter
Humans
Prospective Studies
Sepsis
Anti-Bacterial Agents
Ciprofloxacin