Antibiotic prophylaxis for percutaneous endoscopic gastrostomy in pediatric patients: a meta-analysis

Pediatr Surg Int. 2022 Dec 25;39(1):63. doi: 10.1007/s00383-022-05355-0.

Abstract

Purpose: To investigate if Antibiotic Prophylaxis (AP) can prevent wound and/or systemic infection in pediatric patients who underwent Percutaneous Endoscopic Gastrostomy (PEG).

Methods: PubMed, Embase, and Cochrane databases were searched for Randomized Controlled Trials (RCT) and Observational Studies that compared AP vs. no Intervention (NI) in children submitted to PEG. Odds ratios (OR) with 95% confidence intervals (CI) were pooled with random-effect models. Quality assessment and risk of bias were performed as outlined by Cochrane recommendations.

Results: Four studies, including one RCT, with a total of 568 patients were included, in which 230 (40.5%) individuals received AP. The use of AP during PEG reduced the incidence of systemic infection (OR 0.46; 95% CI 0.24-0.90; p = 0.02; I2 = 0). However, no statistical difference was found for wound infection (OR 0.85; 95% CI 0.43-1.69; p = 0.64; I2 = 12%) and for the composite outcome of any kind of infection (OR 0.74; 95% CI 0.13-4.06; p = 0.73; I2 = 67%).

Conclusion: In this pooled analysis of 568 infants who underwent PEG, the use of AP reduced the incidence of systemic infection. Our results were compatible with findings obtained in the adult population. No differences were found regarding wound infection or the composite outcome of any kind of infection.

Keywords: Antibiotic prophylaxis; Meta-analysis; Pediatric surgery; Percutaneous endoscopic gastrostomy.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis* / methods
  • Child
  • Gastrostomy / methods
  • Humans
  • Incidence
  • Infant
  • Sepsis*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control

Substances

  • Anti-Bacterial Agents