Prolonged Antibiotic Prophylaxis in Patients with Bilioenteric Anastomosis Undergoing Percutaneous Radiofrequency Ablation

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

“…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. In addition, Hoffmann et al [25] suggested that at least 10 days of antibiotic therapy to cover anaerobic bacteria may be helpful in preventing abscess formation in patients with bilioenteric anastomosis who undergo percutaneous radiofrequency ablation. Therefore, although our results did not show usefulness of routine antibiotic prophylaxis in preventing abscess formation after TACE in patients with bilioenteric anastomosis, we carefully speculate that use of vigorous antibiotic prophylaxis as suggested in more recent literature may be effective.…”

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

“…It can appear up to more than 60 d after the procedure [23] . Significant risk factors for its development are the presence of biliary abnormality or manipulation, prone to ascending biliary infection (bilioenteric anastomosis, endoscopic papillotomy and tumor with retention of iodized oil from a previous chemoembolization) [6,12,16,22,24] . In a study conducted by Elias et al [23] in 2006, the authors studied 11 patients with enterobiliary anastomosis or biliary stent and found an incidence of 44% of hepatic abscess in these specific subjects.…”

“…A question that comes up in these patients is if prolonged antibiotic prophylaxis is useful in reducing its incidence. Hoffmann et al [24] addressed this issue and tried to reduced this risk by maintaining the antibiotics for over 10 d after the procedure in 8 patients with prior bilioenteric anastomosis. The majority of the interventions (9/10) had prior administration of intravenous piperacillin/tazobactam and after the RFA, patients received Ciprofloxacin orally; 4 of the patients received additional antibiotics (metronidazole, cefpodoxime and cefazolin).…”

“…The best treatment option is percutaneous drainage in combination with systemic antibiotics [19][20][21]24] . Early suspicion, diagnosis and treatment are essential for a good outcome so the physician should be alert to the patient's clinical follow up, especially in those with risk factors.…”

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

“…As with embolization, patients undergoing liver tumor ablation with a history of biliary colonization as a result of an incompetent sphincter of Oddi are at higher risk for the development of an abscess (158). For these patients, a reduced risk of infectious complications has been associated with administration of biliary-excreted antibiotic agents at the time of the procedure and continued for 5-10 days after (158). Odisio et al (159) reported their experience in 12 patients who underwent microwave ablation and cryoablation with a previous hepaticojejunostomy.…”