Routine Antibiotic Prophylaxis for Totally Implantable Venous Access Device Placement: Meta-Analysis of 2,154 Patients

Johnson, Evan; Babb, James S.; Sridhar, Divya

doi:10.1016/j.jvir.2015.11.051

Cited by 36 publications

(26 citation statements)

References 14 publications

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“…Moreover, in a research of Johnson et al [9] including 2,154 patients undergoing TIVPC placement, 360 patients (16.7%) received antibiotic prophylaxis, while 1,794 (83.3%) received no periprocedural antibiotics. Authors identified 27 infections (1.25%) in the period after the procedure; five occurring in the antibiotic prophylaxis group (1.39%) and 22 in the nonprophylaxis group (1.23%).…”

Section: Discussionmentioning

confidence: 99%

Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years

Yanık

Karamustafaoğlu

Karataş

et al. 2018

Turk Gogus Kalp Dama

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Section: Discussionmentioning

confidence: 99%

Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years

Yanık

Karamustafaoğlu

Karataş

et al. 2018

Turk Gogus Kalp Dama

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“…Despite the lack of formal guidelines recommending the use of preoperative prophylactic antimicrobials for port implantation, a 2013 survey by the American College of Surgery Fellows revealed that 88.2% of respondents routinely used antimicrobial prophylaxis in this setting . A meta‐analysis of 2154 patients investigated at infections related to the port within 30 days of implantation and found that, for patients who did not receive prophylactic antibiotics, the incidence of infection was 1.6% versus 1.1% in those who did receive prophylaxis . With such a low rate of events at baseline and the potential implications associated with receipt of antimicrobials, promotion of resistance, alteration of the microbiome, allergic reactions, and other adverse events, the practice of antimicrobial prophylaxis seems unwarranted until adequately powered randomized studies can support it as a beneficial and safe practice.…”

Section: Surgical Antimicrobial Prophylaxismentioning

confidence: 99%

Implanted vascular access device options: a focused review on safety and outcomes

Blanco-Guzman

2018

Transfusion

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Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications. We review the evidence related to these advances and their effect on the safety profile and complications of implantable vascular access device ports. Since the first report of a fully implantable vascular access device (IVAD) in 1982, 1 the use of these devices has grown exponentially. They consist of a reservoir cradled in the subcutaneous tissue that is connected to a catheter, with its tip terminating into a major vein. IVADs are frequently used in patients who have poor peripheral venous access and are in need of long-term administration of vesicant drugs, antimicrobials, blood products, or parenteral nutrition.2,3 They also are used as access for long-term therapeutic apheresis procedures. 4 Although nonimplanted, long-term catheters can be used for all of these purposes as well, the lack of an external component in IVAD ports provides multiple advantages; patients have improved perceptions of quality of life and body image and less limitation in their mobility. 5 These ports also minimize the need for maintenance care and risk of infectious complications when the IVAD is not in use. 6 These benefits of IVAD port use have also been demonstrated in pediatric cancer patients, with the added advantage of allowing the child to participate in normal activities and preserving body image. 7Despite the vast experience accrued over the years and the large volume of literature studying factors associated with IVAD port outcomes, early perioperative and late postoperative complications still occur (see Table 1). 8,9 Overall complication rates for IVAD ports reportedly occur in the range from 2% to 18% of all implanted devices. 10-12Port-related infections and venous thrombosis are particularly important, because they are associated with additional morbidity and costs and require removal of the IVAD as part of their treatment in as many as 6.5% of patients. 10 An additional complication specific to the use of IVAD ports during therapeutic apheresis is the occurrence of frequent pressure-related alarms, 13-15 which do not always result in a need to abort the procedure but can delay the duration of the treatments and require additional interventions. 13Here, we present a review focused on techniques, materials, and long-term management options of ports as IVAD options that have an impact on the relevant complications and overall safety profile of th...

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“…Recently, the results of systematic review showed that 5 (1.39%) out of 360 patients receiving prophylactic antibiotics experienced an infection, while 22 (1.23%) out of 1794 patients who did not receive an antibiotic experienced an infection; there were no statistical differences between the two groups. This indicates that prophylactic antibiotics had no effect on postoperative infection complications[ 32 ]. Currently, relevant guidelines do not recommend the routine prophylactic use of antibiotics before or during port implantation[ 33 ].…”

Section: Clinical Questionsmentioning

confidence: 99%

“…Currently, relevant guidelines do not recommend the routine prophylactic use of antibiotics before or during port implantation[ 33 ]. Unnecessary use of antibiotics increases the risk of anaphylaxis, leads to the growth of drug-resistant microorganisms, and increases medical expenses[ 32 ].…”

Section: Clinical Questionsmentioning

confidence: 99%

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Zhang

Chen

2020

WJG

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Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time. Advantages of ports include a simple nursing process, low risk of infection and embolism, and high patient comfort. In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications, the Chinese Research Hospital Association Digestive Tumor Committee, the Chinese Association of Upper Gastrointestinal Surgeons, the Chinese Gastric Cancer Association, and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nation-wide expert letter reviews and on-site seminars, and formulated an expert consensus of the operation guidelines.

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Routine Antibiotic Prophylaxis for Totally Implantable Venous Access Device Placement: Meta-Analysis of 2,154 Patients

Abstract: The odds ratio of infection was 0.85 with antibiotic use but one was contained within the confidence interval suggesting no significant difference in infection rate when antibiotics were used.

Cited by 36 publications

References 14 publications

Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years

Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years

Implanted vascular access device options: a focused review on safety and outcomes

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

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