Efficacy of Antibiotic Prophylaxis after Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Preliminary Prospective Study

Takagi, Haruhi; Nagaoka, Tetsutaro; Ando, Kenji; Tsutsumi, Takanobu; Ichikawa, Masaki; Koyama, Ryo; Shimada, Naoko; Tobino, Kazunori; Takahashi, Kazuhisa

doi:10.4172/2161-105x.1000416

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…Therefore, the British Thoracic Society Guidelines for diagnostic and therapeutic bronchoscopy does not recommend antibiotic prophylaxis for the prevention of infection. While we have previously reported that antibiotic prophylaxis was unrelated to the development of fever after the procedure even in EBUS‐TBNA , the preventive effects of prophylactic antibiotics against the infectious complications like a mediastinitis associated with EBUS‐TBNA remain uncertain. Some possible factors associated with the development of mediastinitis after EBUS‐TBNA have been reported as follows: number of times the needle is passed into the lesion, number of samples obtained per lesion, operator expertise, presence of necrotic or cystic lesions, and bacterial contamination of the working channel .…”

Section: Discussionmentioning

confidence: 94%

Severe mediastinitis over a month after endobronchial ultrasound‐guided transbronchial needle aspiration

Kurokawa

Asao

et al. 2019

Respirology Case Reports

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Although endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) has been reported to be a minimally invasive and relatively safe procedure, mediastinitis is a serious complication related to the procedure. The median time of mediastinitis onset is approximately 12 days after EBUS‐TBNA. Here we report two rare cases with mediastinitis onset 40 and 53 days after EBUS‐TBNA. Surgical drainage was performed since systemic treatment with antibiotics was insufficient in both cases. Eikenella corrodens , which is a slow‐growing microorganism, was identified as the causative pathogen in one case. To our knowledge, this is the first report of mediastinitis occurring over a month after EBUS‐TBNA. Clinicians should consider the diagnosis of mediastinitis even if symptoms appear over a month after EBUS‐TBNA.

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Section: Discussionmentioning

confidence: 94%

Severe mediastinitis over a month after endobronchial ultrasound‐guided transbronchial needle aspiration

Kurokawa

Asao

et al. 2019

Respirology Case Reports

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“…There is no clear evidence of the efficacy of prophylactic antibiotics to prevent infectious complications after EBUS‐TBNA. A previous preliminary prospective study did not show any efficacy of antibiotic prophylaxis after EBUS‐TBNA 16 . A study that evaluated the risk factors of infectious complications after EBUS‐TBNA also did not show any benefit of prophylactic antibiotics 10 .…”

Section: Discussionmentioning

confidence: 94%

Delayed onset of mediastinitis with tracheomediastinal fistula following endobronchial ultrasound‐guided transbronchial needle aspiration; A case report

2021

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Infectious complications after endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) are rare but serious. Here, we report a very rare case of delayed onset of mediastinitis with tracheomediastinal fistula after EBUS‐TBNA. Surgical debridement was performed, antibiotics were administered, and the postoperative course of the patient was good. Careful monitoring is needed to prevent the possible development of infectious complications after EBUS‐TBNA.

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“…Until now, routine diagnostic bronchoscopy does not recommend prophylactic antibiotics except for patients who are asplenic, have a heart valve prosthesis, or a previous history of endocarditis [28]. Takagi et al [29] reported that antibiotic prophylaxis in EBUS-TBNA does not affect body temperature and laboratory test related inflammation. However, severe complications, such as mediastinal abscess can have fatal consequences [13,14,16,30].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of and Risk Factors for Fever after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Retrospective Study Involving 6336 Patients

Moon

Choi

Lee

et al. 2020

JCM

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Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic for mediastinal and hilar lymphadenopathy/mass. This study investigated fever incidence and associated risk factors after EBUS-TBNA in 6336 patients who underwent EBUS-TBNA at Asan Medical Center from October 2008 to February 2018. Bronchoscopists evaluated participants’ medical records for fever the 24 h following EBUS-TBNA. Patients were placed in either a Fever group (n = 665) or a non-Fever group (n = 5671). Fever developed in 665 of 6336 patients (10.5%) with a mean peak body temperature of 38.3 °C (range, 37.8–40.6 °C). Multivariate analysis revealed that fever-associated risk factors after EBUS-TBNA are older age (adjusted OR 0.015, 95% CI (0.969–0.997), p = 0.015), bronchoscopic washing (adjusted OR 1.624, 95% CI (1.114–2.368), p = 0.012), more than four samples of EBUS-TBNA (adjusted OR 2.472, 95% CI (1.288–4.745), p = 0.007), hemoglobin levels before EBUS-TBNA (adjusted OR 0.876, 95% CI (0.822–0.933), p < 0.001), CRP levels before EBUS-TBNA (adjusted OR 1.115, 95% CI (1.075–1.157), p < 0.001), and a diagnosis of EBUS-TBNA tuberculosis (adjusted OR 3.409, 95% CI (1.870–6.217), p < 0.001). Clinicians should be aware of the possibility of fever after EBUS-TBNA because it is common. Additional, prospective, large-scale research should assess the need for prophylactic antibiotics for EBUS-TBNA.

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Efficacy of Antibiotic Prophylaxis after Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Preliminary Prospective Study

Cited by 7 publications

References 28 publications

Severe mediastinitis over a month after endobronchial ultrasound‐guided transbronchial needle aspiration

Severe mediastinitis over a month after endobronchial ultrasound‐guided transbronchial needle aspiration

Delayed onset of mediastinitis with tracheomediastinal fistula following endobronchial ultrasound‐guided transbronchial needle aspiration; A case report

Clinical Characteristics of and Risk Factors for Fever after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Retrospective Study Involving 6336 Patients

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