Timing of prophylactic antibiotics administration and suspected systemic infection after percutaneous biliary intervention

• Published in: Journal of hepato-biliary-pancreatic sciences 2024-01, Vol.31 (1), p.34-41
• Main Authors: Im, Hyunjae, Oh, Seung‐Young, Lim, Leerang, Lee, Hannah, Kwon, Jina, Ryu, Ho Geol
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Antibiotics; biliary tract diseases; Biliary Tract Surgical Procedures; complications; Humans; Infections; interventional; radiology; sepsis; Surgical Wound Infection - prevention & control
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.1366

Background/Purpose Prophylactic antibiotics administration before percutaneous biliary intervention (PBI) is currently recommended, but the underlying evidence is mostly extrapolated from prophylactic antibiotics before surgery. The aim of this study was to evaluate the impact of prophylactic antibiotics administration timing on the incidence of suspected systemic infection after PBI. Methods The incidence of suspected systemic infection after PBI was compared in patients who received prophylactic antibiotics at four different time intervals between antibiotics administration and skin puncture for PBI. Suspected post‐intervention systemic infection was assessed according to predetermined clinical criteria. Results There were 98 (21.6%) suspected systemic infections after 454 PBIs in 404 patients. There were significant differences among the four groups in the incidence of suspected systemic infection after the intervention (p = .020). Fever was the most common sign of suspected systemic infection. Administration of prophylactic antibiotics more than an hour before PBI was identified as an independent risk factor of suspected systemic infection after adjusting for other relevant factors (adjusted odds ratio = 10.54; 95% confidence interval, 1.40–78.86). Conclusions The incidence of suspected systemic infection after the PBI was significantly lower when prophylactic antibiotics were administered within an hour before the intervention. The incidence of suspected systemic infection after percutaneous biliary intervention increased significantly when prophylactic antibiotics were administered over 1 h before the intervention. As with preoperative antibiotic prophylaxis to prevent surgical site infection, Im and colleagues recommend administering prophylactic antibiotics within 1 h before percutaneous biliary intervention to minimize infectious complications.