Local Antiseptic Spray Reduces Post-Gastrostomy Infection

Adding a local antiseptic spray to parenteral antibiotics reduces the likelihood of stomal infection after percutaneous endoscopic gastrostomy (PEG), according to a new study.

Researchers from the U.K. National Health Service (NHS) Pennine Acute Hospitals' Trust (Rochdale, UK) studied the effectiveness of local antiseptic spray--with or without a three-dose antibiotic regimen--in preventing stomal infection in 96 patients undergoing PEG placement. The patients were randomized into three groups; the first received 750 mg of cefuroxime intravenously just before the procedure, followed by two further doses every eight hours; the second received a single application of povidone-iodine (Betadine) antiseptic spray; and the third a combination of the two. The stomal site was examined at midweek and at the end of week 1 for evidence of infection.

Stomal infection rates at midweek were lower in the groups that received antibiotics (6%) or antibiotics plus antiseptic spray (9%) than in the group that received antiseptic spray alone (32%). Adverse outcomes (death or infection) were least common in the antibiotics plus antiseptic spray group (6%) and significantly higher in the antibiotic group (35%) and antiseptic spray group (43%). The total number of patients with PEG site infections was lower in the antibiotics-plus-antiseptic spray group (9%) than in the antibiotics-only group (32%) and the antiseptic spray-only group (43%). Besides the treatment only diabetes was found to have a significant effect on outcome. The study was published in the December 2006 edition of the European Journal of Gastroenterology and Hepatology.

"A combined parenteral antibiotic and topical antiseptic prophylactic regime will reduce risk of early PEG site infection,” concluded lead author Dr. Nerukav V. Radhakrishnan and colleagues.

PEG is an endoscopic procedure performed in order to place a gastric feeding tube as a long-term means of providing nutrition to patients who cannot take food orally.



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Pennine Acute Hospitals' Trust