Abstract | BACKGROUND: METHODS: Adults undergoing outpatient bougienage for a benign or malignant esophageal stricture were randomized in a clinician-blinded fashion to either pre-procedure clindamycin mouthwash or no treatment. Subjects were stratified by type of dilator used. Blood cultures were obtained immediately after the first esophageal dilation and 5 minutes after the last dilation. RESULTS: Fifty-nine patients were enrolled: 30 in the treatment arm and 29 in the no-treatment arm. There were 7 positive blood cultures: 5 in the treatment arm and 2 in the no-treatment arm. The identified organisms were Streptococcus viridans (2), Staphylococcus mucilaginous (2), Lactobacillus (2), and Actinomyces odontolyticus (1). Patients with bacteremia reported greater subjective difficulty with dysphagia (p = 0.01) irrespective of stricture diameter, procurement of biopsies, or dilator type. CONCLUSIONS: The percentage of cases with bacteremia for all dilations performed in this manner was 12% (95% CI [5.3, 23.6]), much lower than previously cited. All organisms in this study were oral commensals. There appears to be no effect of a clindamycin mouthwash on reducing bacteremia after esophageal dilation.
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Authors | W K Hirota, G W Wortmann, C L Maydonovitch, A S Chang, R B Midkiff, R K Wong, F M Moses |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 50
Issue 4
Pg. 475-9
(Oct 1999)
ISSN: 0016-5107 [Print] United States |
PMID | 10502166
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Anti-Bacterial Agents
- Mouthwashes
- Clindamycin
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Topics |
- Aged
- Anti-Bacterial Agents
(administration & dosage)
- Antibiotic Prophylaxis
- Bacteremia
(microbiology, prevention & control)
- Bacteria
(isolation & purification)
- Clindamycin
(administration & dosage)
- Dilatation
(adverse effects, instrumentation)
- Esophageal Stenosis
(therapy)
- Female
- Humans
- Male
- Middle Aged
- Mouth
(microbiology)
- Mouthwashes
- Prospective Studies
- Single-Blind Method
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