Results of antibiotic prophylaxis in post push percutaneous endoscopic gastrostomy (push PEG) patient at Phaholpolpayuhasena hospital

Abstract

Percutaneous endoscopic gastrostomy (PEG) is an endoscopy assisted feeding gastrostomy tube placement. The gastrostomy tube is pushed from abdominal wall into the body of stomach without pulling the tube through skin tract, therefore push PEG reduces the risk of gastrostomy site contamination and infection.

This study showed the treatment outcomes comparing in antibiotic prophylaxis group and anti-septic solution only group. The primary outcome is gastrostomy site infection rate. The secondary outcomes are length of hospital stay, operative time, estimate blood loss and complication rate.

Retrospective chart review of 100 patients, who was underwent push percutaneous endoscopic gastrostomy (PEG) from January 2016 – December 2020 in single institute database. The antibiotic prophylaxis group (n=25) which received conventional skin preparation with anti-septic solution and intravenously antibiotic prophylaxis base on institutional protocol. Whereas the anti-septic solution only group (n=75), skin is prepared with anti-septic solution same protocol as the other group. The gastrostomy site infection rate in antibiotic prophylaxis group is 4% (n=1) and anti-septic solution only group is 2.7% (n=2). Total complication rate is 12% (n=3) and 6.7% (n=5), respectively. (p=0.395)

From this study, there is no statistical significant difference among antibiotic prophylaxis group and anti-septic solution only group in term of gastrostomy site infection rateand total complication rate. Therefore, this could be an alternative preoperative management in push PEG procedure to reduction the risk of antibiotic adverse effects event and cost of treatment.