The role of antibiotic prophylaxis in totally implantable venous access device placement: results of a single-center prospective randomized trial.

Author(s): Karanlik H, Kurul S, Saip P, Unal ES, Sen F, Disci R, Topuz E

Affiliation(s): Department of Surgery, Istanbul University, Institute of Oncology, Capa, Turkey. hasankaranlik@yahoo.com

Publication date & source: 2011-07, Am J Surg., 202(1):10-5. Epub 2011 May 23.

Publication type: Randomized Controlled Trial

BACKGROUND: This study evaluated whether prophylactic treatment with a cefazolin could prevent infections in patients who had a surgically inserted totally implantable venous access device (TIVAD). METHODS: We conducted a prospective, randomized, double-blind, placebo-controlled trial comparing wound infection rates in 404 patients (203 received prophylactic cefazolin, 201 received a placebo) undergoing TIVAD insertion. Infections were evaluated 3, 7, 14, and 30 days after discharge and outcomes were compared and analyzed. RESULTS: Groups were well matched for all preoperative variables studied, including comorbid conditions. Superficial surgical site infection developed in 5 patients (2.5%) from the antibiotic group and 6 (3%) from the placebo group (P = .75). One from each group developed deep surgical site infection. Both patients were readmitted and underwent repeated debridement, which eventually resulted in port loss in 1 patient. CONCLUSIONS: We do not recommend the use of prophylactic antibiotics in TIVAD insertion because they will not decrease the already low rate of postoperative infectious complications. Registration number NCT00867295 (http://www.clinicaltrials.gov). Copyright (c) 2011 Elsevier Inc. All rights reserved.