Clinical significance of antibiotic prophylaxis in perioperative period of intravascular interventional therapy

Abstract:

Objective：To investigate the protective effect of antibiotic prophylaxis against postoperative infection in perioperative peri－od of intravascular interventional therapy. Methods：Clinical data of inpatients with liver cancer undergoing transarterial chemoem－bolization（TACE） from January 2007 to March 2013 or inpatients with cirrhosis undergoing transjugularintrahepatic portosystemic shunts（TIPS） from January 2011 to March 2013 were collected and retrospectively analyzed. There were 538 patients undergoing TACE，including 501 males and 37 females，with an average age of （52.87±12.33）-year-old. There were 61 patients undergoing TIPS including 47 males and 14 females，with an average age of （47.52±9.55）-year-old. According to antibiotic prophylaxis in periopera－tive period of TACE and TIPS，inpatients were classified into TACE antibiotic prophylaxis treatment group，TACE non antibiotic pro－phylaxis treatment group，TIPS antibiotic prophylaxis treatment group and TIPS non antibiotic prophylaxis treatment group. Postopera－tive infection rate and risk factors of infection were analyzed and compared. Results：The postoperative infection rate of TACE antibi－otic prophylaxis treatment group and TACE non antibiotic prophylaxis treatment group were 16.71%（60/359） and 20.11%（36/179） respectively（P=0.33）. Univariate and multivariate analyses indicated that Child-Pugh score and operation time over 2 h were indepen－dent risk factors. The postoperative infection rate of TIPS antibiotic prophylaxis treatment group was 33.33（5/15） and that of TIPS non antibiotic prophylaxis treatment group was 34.78（16/46）（P=0.92）. Multivariate analysis showed that age and Child-Pugh score were independent risk factors. Conclusion：Antibiotic prophylaxis in patients with Child-Pugh A undergoing TACE or TIPS therapy is not routinely necessary. However，it is more reasonable to use appropriate antibiotics for the high-risk group who have poor liver func－tion，long operation time and advanced age.