Moxifloxacin Prophylaxis for Chemoembolization or Embolization in Patients With Previous Biliary Interventions: A Pilot Study

Khan, Waseem Ullah; Sullivan, Kevin L.; McCann, Jeffrey W.; Gonsalves, Carin F.; Sato, Takami; Eschelman, David J.; Brown, Daniel B.

doi:10.2214/ajr.10.6019

Cited by 54 publications

(31 citation statements)

References 9 publications

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“…The antibiotics given usually were a third-generation cephalosporin with or without metronidazole. In the literature, controversy persists over the role of antibiotics in preventing abscess [8,[13][14][15]. A few studies, however, have shown promising results that vigorous antibiotic prophylaxis may be helpful in preventing liver abscess.…”

Section: Discussionmentioning

confidence: 99%

“…A few studies, however, have shown promising results that vigorous antibiotic prophylaxis may be helpful in preventing liver abscess. Khan et al [15] observed no development of abscess after TACE in patients with previous biliary interventions when moxifloxacin, an antibiotic with a high degree of biliary secretion, was administered. Geschwind et al [14] reported that prophylaxis with tazobactampiperacillin and bowel preparation resulted in no abscess formation in patients who underwent bilioenteric anastomosis followed by chemoembolization.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Liver Abscess After Transarterial Chemoembolization in Patients With Bilioenteric Anastomosis: Frequency and Risk Factors

Woo

Chung²,

Hur³

et al. 2013

American Journal of Roentgenology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Liver Abscess After Transarterial Chemoembolization in Patients With Bilioenteric Anastomosis: Frequency and Risk Factors

Woo

Chung²,

Hur³

et al. 2013

American Journal of Roentgenology

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“…The IR suite can be considered to be a ''very high risk area'' for the transmission of HCAIs [33,80]. Reduction of infection in IR requires the appropriate use of antibiotic prophylaxis [81,82], identification of risk factors, and the appropriate pre-, intra-, and post-procedural care of the patients undergoing interventions. The Society of Interventional Radiology Clinical Practice Guidelines provides advice on the effective antibiotic prophylaxis for vascular and IR depending on the causative pathogens, procedure-specific likelihood of infection risks, and appropriate coverage [19].…”

Section: Hcais and Interventional Radiologymentioning

confidence: 99%

Health Care–Associated Infections and the Radiology Department

Ilyas

Burbridge

Babyn

2019

Journal of Medical Imaging and Radiation Sciences

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Health care-associated infections (HCAIs) are a significant concern for both health care workers (HCWs) and patients. They are a major contributing factor of disease in industrialized countries, and are responsible for significant morbidity, mortality, and a direct annual financial loss of $6-7 billion in North America alone. They are an increasingly challenging health issue due to multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci among others, along with an increasing number of susceptible patients. Over the last three decades, the risk of HCAIs has increased in the radiology department (RD) in part because of an increased number of patients visiting the department and an increase in the utilization of imaging modalities. In this review, we will discuss how patients and staff can be exposed to HCAIs in the RD, including contaminated inanimate surfaces, radiology equipment, and associated medical devices. As the role of medical imaging has extended from primarily diagnosis to include more interventions, the implementation and development of standardized infection minimization protocols and infection control procedures are vital in the RD, particularly in interventional radiology. With globalisation and the rapid movement of people regionally, nationally, and globally, there is greater risk of exposure to contagious diseases such as Ebola, especially if infected patients are undiagnosed when they travel. For effective infection control, advanced training and education of HCWs in the RD is essential.The purpose of this article is to provide an overview of HCAIs as related to activities of the RD. We will discuss the following major topics including the variety of HCAIs commonly encountered, the role of the RD in HCAIs, transmission of infections to patients and HCWs in the RD, standard infection prevention measures, and the management of susceptible/infected patients in the RD. We shall also examine the role of, and the preparedness of, HCWs, including RD technologists and interventional radiologists, who may be exposed to undiagnosed, yet infected patients. We shall conclude with a brief discussion of the role of further research related to HCAIs. Learning ObjectivesAfter the completion of this review article, the readers will Understand the exposure and role of radiology department in health care-associated infections, Know the causes/modes/transmission of infections in radiology department, Be conscious of standard disinfection protocols, Be aware of current and future strategies required for the effective control of health care-associated infection in the radiology department. This is a CME article and provides the equivalent of 2 hours of continuing education that may be applied to your professional development credit system. A 10-question multiple-choice quiz follows this reading. Please note that no formalized credit (category A) is available from CAMRT.

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“…In such patients, the use of prophylactic antibiotic agents against Gram-positive skin flora and Gram-negative enteric flora is recommended (76). Recently, Khan et al (83) showed that a 21-day course of moxifloxacin (Avelox; Bayer, Whippany, New Jersey) is an effective regimen in patients with previous biliary interventions, with 0 infectious complications in 10 patients who underwent 25 procedures. A more aggressive regimen described by Patel et al in 2006 (84) that included levofloxacin and metronidazole begun 2 days before the procedure and continued for 2 weeks afterward (plus cathartic bowel preparation) demonstrated a trend toward a lower incidence of abscess formation compared with studies without antibiotic prophylaxis.…”

Section: Hepatic Embolization and Chemoembolizationmentioning

confidence: 99%

“…Generally speaking, the risk of abscess formation with radioembolization is thought to be lower than that encountered with chemoembolization given the reduced ischemia created by the microspheres (82). When adhering to a 21-day course of multidrug prophylaxis plus bowel preparation, Khan et al (83) showed that the risk of hepatic abscess formation with radioembolization (0 of 16) was lower than that with chemoembolization (3 of 13) in patients with a history of sphincter of Oddi incompetence.…”

Section: Radioembolizationmentioning

confidence: 99%

Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology

Chehab

Thakor

Tulin-Silver

et al. 2018

Journal of Vascular and Interventional Radiology

107

103

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CI ¼ confidence interval, IV ¼ intravenous, IVC ¼ inferior vena cava, TIPS ¼ transjugular intrahepatic portosystemic shunt, UAE ¼ uterine artery embolization PREAMBLE In 2010, the Society of Interventional Radiology (SIR) published its first practice guidelines regarding the use of antibiotic prophylaxis in vascular and interventional radiology (IR) (1). The present update to the original guidelines aims to address the expanding breadth of IR procedures, including the increasing prevalence of pediatric IR procedures, and the increasing repertoire of antibacterial agents. As was the case for the original guidelines (1), the availability of randomized controlled data regarding antibiotic prophylaxis is lacking in the IR literature. Much data are derived from retrospective reviews

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Moxifloxacin Prophylaxis for Chemoembolization or Embolization in Patients With Previous Biliary Interventions: A Pilot Study

Abstract: Ten patients underwent 25 procedures and were followed for a median of 250 days. No abscesses developed. Our results suggest moxifloxacin alone may suffice for prophylaxis.

Cited by 54 publications

References 9 publications

Liver Abscess After Transarterial Chemoembolization in Patients With Bilioenteric Anastomosis: Frequency and Risk Factors

Liver Abscess After Transarterial Chemoembolization in Patients With Bilioenteric Anastomosis: Frequency and Risk Factors

Health Care–Associated Infections and the Radiology Department

Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology

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