番茄社区

AUSTIN, Texas -- It wasn't use of prophylactic antibiotics, but certain patient factors that appeared to affect infection rates in the 30 days after chest port placement, researchers found in a large retrospective study.

Patient age, race, and gender had no relationship with infection. However, infection was more likely with the following patient factors, at high levels of statistical significance and irrespective of whether antibiotics were administered:

• History of smoking: OR 1.67 with antibiotics vs OR 1.47 without
• Diabetes: OR 1.91 with vs OR 1.86 without

• Dialysis: OR 2.16 with vs OR 2.36 without

• Neutropenia: OR 2.76 with vs OR 2.42 without

• HIV: OR 3.07 with vs OR 3.57 without

That pre-operative antibiotics made no difference in the risk of infection (1.72% with antibiotics vs 1.41% without) is in line with previous literature, according to the presentation by Lisa Walker, MD, of University Hospitals Cleveland Medical Center, at the annual meeting of the .

This may have implications for hospitals trying to cover their bases by giving antibiotics indiscriminately, the investigator suggested, as "the routine administration of pre-operative antibiotics before chest port adds to unnecessary patient risk, excess cost, and antibiotic resistance."

Walker added that hematologic malignancies (but not solid organ malignancies) did correlate with increased risk of infection. She did not present those statistics here, however, noting that they would appear in an upcoming paper.

The study relied on an IBM Watson Explorys database that included patients with chest port placement given antibiotic prophylaxis (n=153,120) or not (n=149,350).

Walker acknowledged that the study was limited by the potential of incorrect or missing codes in the database. Moreover, the authors couldn't differentiate between patients who developed infection from poor technique or poor hygiene.

Nevertheless, "our study shows no associated differences in infection rates after the administration of pre-operative antibiotics prior to port placement regardless of patient risk factor," she concluded.

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