Peroral endoscopic myotomy (POEM) is an endoscopic procedure that exposes the contents of the esophagus to the sterile mediastinum during the myotomy. This allows microbial translocation to occur and presents a risk of local and systemic infection. This study evaluated the role of single-dose intravenous (IV) antibiotics versus a short course of antibiotics in POEM patients. <\/p>\n\n\n\n
In this prospective randomized controlled trial, patients undergoing POEM were randomized to receive a single dose of a prophylactic antibiotic or a short course of antibiotics. The prophylaxis group (group A: n=62; age, 58.5 \u00b1 14.6 years; 33 males) was given 2 gm of cefazolin intravenously before the procedure. The short-course antibiotic group (group B: n=62; age, 55.9 \u00b1 15.35 years; 31 males) received 2 gm of cefazolin intravenously for 24 hours, followed by 3 mg of amoxicillin\/clavulanate per day for 3 days. Patients allergic to beta-lactams were given an equivalent dose of clindamycin. <\/p>\n\n\n\n
Prior to hospitalization, initial lab work was collected to establish a baseline. Body temperature and repeat labs were obtained 1 hour before the procedure as well as 1 hour and 24 hours after the procedure. None of the enrolled patients developed a fever after POEM except 1 in group B. There were no differences in the absolute body temperatures between groups A and B. Furthermore, there were no significant differences between the 2 groups in systemic inflammation markers, such as C-reactive protein, white blood cell count 24 hours after POEM, lipopolysaccharide-binding protein, IL-6, and tumor necrosis factor-\u03b1. <\/p>\n\n\n\n
One hour before POEM, blood cultures from all patients were negative. One hour after POEM, 3 of 124 patients (2.4%) had positive blood cultures for Streptococcus<\/em> spp, including 1 patient (1.6%) in the prophylaxis group and 2 (3.2%) in the short-course antibiotic group. All patients had negative blood cultures 24 hours after POEM, suggesting transient bacteremia in these 3 patients. At day 5 of follow-up after discharge, no infections, fevers, or other complications were reported.<\/p>\n","protected":false},"excerpt":{"rendered":" Peroral endoscopic myotomy (POEM) is an endoscopic procedure that exposes the contents of the esophagus to the sterile mediastinum during the myotomy. This allows microbial translocation to occur and presents a risk of local and systemic infection. This study evaluated the role of single-dose intravenous (IV) antibiotics versus a short course of antibiotics in POEM … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1791],"tags":[2098,3092,2578,237],"class_list":["post-11362","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-esophagus","tag-esophagus-2","tag-intravenous-iv-antibiotics-versus","tag-peroral-endoscopic-myotomy-2","tag-poem"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/11362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=11362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=11362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=11362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}