The role of antibiotic prophylaxis in totally implantable venous access device placement: results of a single-center prospective randomized trial.

Abstract

BACKGROUND:

This study evaluated whether prophylactic treatment with a cefazolin could prevent infections in patients who had a surgically inserted totally implantable venous access device (TIVAD).

METHODS:

We conducted a prospective, randomized, double-blind, placebo-controlled trial comparing wound infection rates in 404 patients (203 received prophylactic cefazolin, 201 received a placebo) undergoing TIVAD insertion. Infections were evaluated 3, 7, 14, and 30 days after discharge and outcomes were compared and analyzed.

RESULTS:

Groups were well matched for all preoperative variables studied, including comorbid conditions. Superficial surgical site infection developed in 5 patients (2.5%) from the antibiotic group and 6 (3%) from the placebo group (P = .75). One from each group developed deep surgical site infection. Both patients were readmitted and underwent repeated debridement, which eventually resulted in port loss in 1 patient.

CONCLUSIONS:

We do not recommend the use of prophylactic antibiotics in TIVAD insertion because they will not decrease the already low rate of postoperative infectious complications. Registration number NCT00867295 (http://www.clinicaltrials.gov).

• Authors: Hasan Karanlik, Sidika Kurul, Pinar Saip, Ersin Selcuk Unal, Fatma Sen, Rian Disci, Erkan Topuz
• Journal: American journal of surgery (Am J Surg) Vol. 202 Issue 1 Pg. 10-5 (Jul 2011) ISSN: 1879-1883 [Electronic] United States
• PMID: 21601826 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Cefazolin

Topics

• Anti-Bacterial Agents (therapeutic use)
• Antibiotic Prophylaxis
• Catheter-Related Infections (epidemiology, prevention & control)
• Catheterization, Central Venous (adverse effects)
• Catheters, Indwelling (adverse effects)
• Cefazolin (therapeutic use)
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Surgical Wound Infection (prevention & control)