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lüll Antibiotic prophylaxis for percutaneous endoscopic gastrostomy for non-malignant conditions: a double-blind prospective randomized controlled trial Saadeddin A; Freshwater DA; Fisher NC; Jones BJAliment Pharmacol Ther 2005[Sep]; 22 (6): 565-70BACKGROUND: The use of antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy insertion has been encouraged following development of guidelines by a number of professional societies within the past few years. However, not all evidence supports routine prophylaxis, particularly in patients with 'benign' disease indications for percutaneous endoscopic gastrostomy insertion. AIM: To identify whether prophylactic antibiotic usage is beneficial in patients undergoing percutaneous endoscopic gastrostomy insertion without malignant disease. METHODS: Adult patients without malignant disease who were referred for percutaneous endoscopic gastrostomy insertion at our unit were assessed for participation in this prospective, double-blind, randomized controlled study. Patients were randomized to receive either placebo or 2.2 g co-amoxiclav (or 2 g cefotaxime if penicillin-allergic) at time of percutaneous endoscopic gastrostomy insertion. Clinical endpoints studies were percutaneous endoscopic gastrostomy site or systemic infection and death within 7 days of percutaneous endoscopic gastrostomy insertion. Results : Ninety-nine patients completed the study (51 antibiotics, 48 placebo). Outcomes in the antibiotic and placebo groups respectively were: percutaneous endoscopic gastrostomy site infection, 11% vs. 47% (P < 0.01); systemic infection, 16% vs. 38% (P < 0.05); and death, 8% vs. 15% (P = 0.5). CONCLUSIONS: Antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy insertion reduces both percutaneous endoscopic gastrostomy site and systemic infections in patients without malignant disease.|*Antibiotic Prophylaxis[MESH]|Aged[MESH]|Amoxicillin-Potassium Clavulanate Combination/*therapeutic use[MESH]|Anti-Bacterial Agents/*therapeutic use[MESH]|Cefotaxime/*therapeutic use[MESH]|Double-Blind Method[MESH]|Female[MESH]|Gastroscopy/*adverse effects/methods[MESH]|Gastrostomy/*adverse effects/methods[MESH]|Humans[MESH]|Intubation, Gastrointestinal/adverse effects[MESH]|Male[MESH]|Prospective Studies[MESH]|Surgical Wound Infection/*prevention & control[MESH] |