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Antibiotic prophylaxis for endoscopic retrograde chlangiopancreatography increases the detection rate of drug‐resistant bacteria in bile
Author(s) -
Minami Tomoyuki,
Sasaki Tamito,
Serikawa Masahiro,
Ishigaki Takashi,
Murakami Yoshiaki,
Chayama Kazuaki
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.129
Subject(s) - antibiotics , medicine , antibiotic prophylaxis , antibiotic resistance , biliary tract , bacteria , drug resistance , drug , adverse effect , endoscopic retrograde cholangiopancreatography , gastroenterology , biliary drainage , microbiology and biotechnology , biology , pharmacology , genetics , pancreatitis
Abstract Background No consensus has yet been reached regarding the utility of antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography ( ERCP ). However, there has been little discussion of potential adverse effects of antibiotic use. This study investigated the impact of antibiotic prophylaxis on overall levels of bacterial infiltration of the biliary tract and the prevalence of drug‐resistance among that population. Methods Ninety‐three patients, from whom intraoperative bile samples were collected after performing ERCP , were assigned to either an antibiotic‐prophylaxis group ( AP , n = 58) or a no‐antibiotic‐prophylaxis group ( NAP , n = 35). Detection rates of biliary bacteria and antibiotic resistance were determined for each group. Multivariate analysis was also performed to identify risk factors for the development of drug‐resistant biliary bacteria. Results The bile contamination rate was 37.1% for the NAP group and 55.2% for the AP group ( P = 0.09). Drug‐resistant bacteria were found in 5.7% of the NAP group and 29.3% of the AP group ( P = 0.006). Biliary drainage and antibiotic prophylaxis for ERCP were identified as risk factors for the presence of drug‐resistant bacteria. Conclusion Administration of antibiotic prophylaxis prior to ERCP can be a risk factor for the selection of drug‐resistant bacteria in the biliary tract.