Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology · 2018
Antibiotic prophylaxis in transarterial chemoembolization of hepatocellular carcinoma.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Mansour Mohamed Awad, Khalifa Mohamed Omar
Аннотация
BACKGROUND AND STUDY AIMS: Transarterial chemoembolization remains a common treatment option in unresectable hepatocellular carcinoma. However, protocols for pre- and post-procedure care and the role of antibiotic prophylaxis have not been evaluated. The aim of this work was to compare 3 different groups of prophylactic antibiotics in patients undergoing chemoembolization and to compare the efficacy of intravenous versus oral route.
PATIENTS AND METHODS: 180 hepatocellular carcinoma patients undergoing transarterial chemoembolization were selected. Patients were classified into 3 groups; Group 1: 60 patients; 30 received intravenous ceftriaxone, and 30 received oral cefixime. Group 2: 60 patients; 30 patients received intravenous levofloxacin and 30 received oral levofloxacin. Group 3: 60 patients; 30 received intravenous ciprofloxacin and 30 received oral ciprofloxacin. All antibiotics were given one day before intervention and for 4 days afterwards. Complete blood count, C-reactive protein, liver and renal function tests were assessed 1 and 5 days and then 1 month after the procedure.
RESULTS: The ciprofloxacin group gave better results than the other 2 groups regarding total and differential leucocytic count and C-reactive protein level. No significant difference was found between oral and intravenous routes among the 3 groups. None of the studied patients developed infections or liver abscess after chemoembolization.
CONCLUSION: Third generation cephalosporin, levofloxacin or ciprofloxacin all are effective as prophylaxis against post-chemoembolization infections. No significant difference between oral and intravenous administration among the 3 groups. Oral ciprofloxacin is an effective, safe and relatively inexpensive prophylaxis regimen.
PATIENTS AND METHODS: 180 hepatocellular carcinoma patients undergoing transarterial chemoembolization were selected. Patients were classified into 3 groups; Group 1: 60 patients; 30 received intravenous ceftriaxone, and 30 received oral cefixime. Group 2: 60 patients; 30 patients received intravenous levofloxacin and 30 received oral levofloxacin. Group 3: 60 patients; 30 received intravenous ciprofloxacin and 30 received oral ciprofloxacin. All antibiotics were given one day before intervention and for 4 days afterwards. Complete blood count, C-reactive protein, liver and renal function tests were assessed 1 and 5 days and then 1 month after the procedure.
RESULTS: The ciprofloxacin group gave better results than the other 2 groups regarding total and differential leucocytic count and C-reactive protein level. No significant difference was found between oral and intravenous routes among the 3 groups. None of the studied patients developed infections or liver abscess after chemoembolization.
CONCLUSION: Third generation cephalosporin, levofloxacin or ciprofloxacin all are effective as prophylaxis against post-chemoembolization infections. No significant difference between oral and intravenous administration among the 3 groups. Oral ciprofloxacin is an effective, safe and relatively inexpensive prophylaxis regimen.