Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics

<h4>Background and aim</h4> Prophylactic administration of antibiotics within 24 hours of surgery is recommended to reduce the risk of infection. We conducted a prospective study to compare the efficacy of single administration of antibiotics with a historical control of continuous admin...

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Autores principales:	Ryo Nakagomi, Ryosuke Tateishi, Shintaro Mikami, Taijiro Wake, Mizuki Nishibatake Kinoshita, Takuma Nakatsuka, Tatsuya Minami, Masaya Sato, Koji Uchino, Kenichiro Enooku, Hayato Nakagawa, Yoshinari Asaoka, Shuichiro Shiina, Kazuhiko Koike
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ecc87d01ec004fa0ad29dd8900796aac
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spelling	oai:doaj.org-article:ecc87d01ec004fa0ad29dd8900796aac2021-11-25T06:19:28ZInfectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics1932-6203https://doaj.org/article/ecc87d01ec004fa0ad29dd8900796aac2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604344/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and aim</h4> Prophylactic administration of antibiotics within 24 hours of surgery is recommended to reduce the risk of infection. We conducted a prospective study to compare the efficacy of single administration of antibiotics with a historical control of continuous administration of antibiotics for radiofrequency ablation (RFA) of malignant liver tumors. <h4>Methods</h4> Between February 1, 1999 and November 30, 2010, a total of 6,763 RFA treatments were performed in 2,355 patients, using a protocol with continuous administration of prophylactic antibiotics. On December 1, 2010, we began using a revised protocol with a single administration of prophylactic antibiotics, while continuing to use the old continuous administration protocol for patients who declined the new protocol. Interim analysis was performed to assess the safety of the single administration protocol. Thereafter, from April 1, 2012, all patients were treated using the new protocol. Risk factors for infectious complications of RFA were assessed using logistic regression. <h4>Results</h4> From December 2010 to March 2012, 766 RFA treatments were performed in 663 patients using the new antibiotic protocol. Infectious complications were observed following 4 of these treatments (0.52%). As the upper limit of the confidence interval (CI) resulting from a one-sided binomial test was exactly the prespecified limit of 1.0%, from April 2012 onwards, we treated all patients using the new protocol with single administration of prophylactic antibiotics. A total of 3,547 RFA treatments were performed using the single administration protocol. Univariable logistic regression indicated that prior transcatheter arterial chemoembolization (TACE) and maximal tumor diameter were significant risk factors for infectious complications (P = 0.04 and P < 0.001, respectively). Multivariable analysis indicated that the adjusted hazard ratio of single vs. continuous administration of antibiotics was 1.20 (95% CI: 0.53–2.75; P = 0.66). <h4>Conclusions</h4> The rate of infectious complications related to RFA was acceptably low. Single administration of prophylactic antibiotics did not significantly increase the rate of infectious complications related to RFA, compared with a more intensive antibiotic protocol.Ryo NakagomiRyosuke TateishiShintaro MikamiTaijiro WakeMizuki Nishibatake KinoshitaTakuma NakatsukaTatsuya MinamiMasaya SatoKoji UchinoKenichiro EnookuHayato NakagawaYoshinari AsaokaShuichiro ShiinaKazuhiko KoikePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ryo Nakagomi Ryosuke Tateishi Shintaro Mikami Taijiro Wake Mizuki Nishibatake Kinoshita Takuma Nakatsuka Tatsuya Minami Masaya Sato Koji Uchino Kenichiro Enooku Hayato Nakagawa Yoshinari Asaoka Shuichiro Shiina Kazuhiko Koike Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics
description	<h4>Background and aim</h4> Prophylactic administration of antibiotics within 24 hours of surgery is recommended to reduce the risk of infection. We conducted a prospective study to compare the efficacy of single administration of antibiotics with a historical control of continuous administration of antibiotics for radiofrequency ablation (RFA) of malignant liver tumors. <h4>Methods</h4> Between February 1, 1999 and November 30, 2010, a total of 6,763 RFA treatments were performed in 2,355 patients, using a protocol with continuous administration of prophylactic antibiotics. On December 1, 2010, we began using a revised protocol with a single administration of prophylactic antibiotics, while continuing to use the old continuous administration protocol for patients who declined the new protocol. Interim analysis was performed to assess the safety of the single administration protocol. Thereafter, from April 1, 2012, all patients were treated using the new protocol. Risk factors for infectious complications of RFA were assessed using logistic regression. <h4>Results</h4> From December 2010 to March 2012, 766 RFA treatments were performed in 663 patients using the new antibiotic protocol. Infectious complications were observed following 4 of these treatments (0.52%). As the upper limit of the confidence interval (CI) resulting from a one-sided binomial test was exactly the prespecified limit of 1.0%, from April 2012 onwards, we treated all patients using the new protocol with single administration of prophylactic antibiotics. A total of 3,547 RFA treatments were performed using the single administration protocol. Univariable logistic regression indicated that prior transcatheter arterial chemoembolization (TACE) and maximal tumor diameter were significant risk factors for infectious complications (P = 0.04 and P < 0.001, respectively). Multivariable analysis indicated that the adjusted hazard ratio of single vs. continuous administration of antibiotics was 1.20 (95% CI: 0.53–2.75; P = 0.66). <h4>Conclusions</h4> The rate of infectious complications related to RFA was acceptably low. Single administration of prophylactic antibiotics did not significantly increase the rate of infectious complications related to RFA, compared with a more intensive antibiotic protocol.
format	article
author	Ryo Nakagomi Ryosuke Tateishi Shintaro Mikami Taijiro Wake Mizuki Nishibatake Kinoshita Takuma Nakatsuka Tatsuya Minami Masaya Sato Koji Uchino Kenichiro Enooku Hayato Nakagawa Yoshinari Asaoka Shuichiro Shiina Kazuhiko Koike
author_facet	Ryo Nakagomi Ryosuke Tateishi Shintaro Mikami Taijiro Wake Mizuki Nishibatake Kinoshita Takuma Nakatsuka Tatsuya Minami Masaya Sato Koji Uchino Kenichiro Enooku Hayato Nakagawa Yoshinari Asaoka Shuichiro Shiina Kazuhiko Koike
author_sort	Ryo Nakagomi
title	Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics
title_short	Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics
title_full	Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics
title_fullStr	Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics
title_full_unstemmed	Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics
title_sort	infectious complications related to radiofrequency ablation of liver tumors: the role of antibiotics
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ecc87d01ec004fa0ad29dd8900796aac
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Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics

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