No need for antibiotics before placing venous access device
Last Updated: 2011-03-28 13:40:18 -0400 (Reuters Health)
By Karla Gale
NEW YORK (Reuters Health) - Stop giving routine antibiotics before placing a venous access device -- that was the message some New York researchers delivered today at the 36th annual scientific meeting of the Society of Interventional Radiology in Chicago.
Out of 1158 patients who had these devices implanted in 2009 at Memorial Sloan-Kettering Cancer Center, less than 1% developed early infections without prophylaxis, they reported.
More than 90% of the patients received chemo through their ports within 30 days.
"This isn't a sexy topic, and it's not talked about much," although most clinicians use antibiotic prophylaxis before implanting a venous access device, presenter Dr. Anne M. Covey told Reuters Health.
"But this is a clean procedure that takes very little time, and there's no data to support its use," she added.
Thirteen patients (1.1%) had ports removed within 30 days; seven of these patients (0.6%) had a blood-stream infection within the same time period.
Even after accounting for the 82 patients on antibiotics when the IVAD was placed and the 37 patients who died within 30 days of implantation, the blood infection rate was still only 0.7%, "which compares favorably to contemporary series in which antibiotics are routinely given," the researchers said in their abstract.
Antibiotic prophylaxis is not without consequences, Dr. Covey noted, particularly in terms of potential antibiotic resistance.
Furthermore, "in an earlier study among healthy people given one dose of cephalosporin - the antibiotic used most often for prophylaxis -- about 30% developed culturable Clostridium difficile in their stool, and eight out of 40 had diarrhea."
And given that more than 5 million central lines are placed annually in the U.S., the implications are "not trivial," she added.
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