Editorials

Antibiotic prophylaxis after percutaneous endoscopic gastrostomy

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c2898 (Published 02 July 2010) Cite this as: BMJ 2010;341:c2898
  1. Matthew Kurien, research fellow in gastroenterology,
  2. David S Sanders, consultant gastroenterologist
  1. 1Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield S10 2JF
  1. david.sanders{at}sth.nhs.uk

    Co-trimoxazole given through the tube after insertion shows promising results

    Percutaneous endoscopic gastrostomy (PEG) was introduced into clinical practice in 1980.1 PEG is an effective way of providing enteral feeding to patients who have functionally normal gastrointestinal tracts but who cannot meet their nutritional needs because of inadequate oral intake.1 PEG insertion rates are rising—more than 15 000 procedures are undertaken in the United Kingdom each year, and rates are similar internationally.2 3

    After PEG insertion, 30 day mortality and complication rates are high.4 The most common complication is wound (insertion site) infection, with reported rates varying from 4% to 30%.5 Patients are often susceptible to infection because of their reduced nutritional status, advanced age, and underlying disease.6 7 To avoid wound infection and the potential associated morbidity and mortality, conventional practice is to use prophylactic systemic antibiotics. International guidelines recommend the use of intravenous co-amoxiclav or a second or third generation cephalosporin before gastrostomy insertion.7 8 This is based on reduced …

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