Meta-analysis of randomized, controlled trials of antibiotic prophylaxis before percutaneous endoscopic gastrostomy

OBJECTIVES: We sought to review the published literature on the value of antibiotic prophylaxis for the prevention of wound infection that occurs after percutaneous endoscopic gastrostomy. We also sought by meta-analysis to estimate the efficacy of antibiotic prophylaxis in preventing wound infection. METHODS: We performed a fully recursive literature search for randomized, controlled trials of antibiotic prophylaxis against wound infection occurring after percutaneous endoscopic gastrostomy. Relative and absolute risk reductions and the numbers needed to treat were derived for individual trials and pooled data. RESULTS: We identified seven trials, two of which did not find a statistically significant benefit of antibiotic prophylaxis. After pooling, antibiotic prophylaxis was found to reduce the relative and absolute risk of wound infection by 73% and 17.5%, respectively. The number needed to treat to prevent one wound infection was 5.7 (95% confidence interval = 4.4-8.0). CONCLUSION: A single intravenous dose of a broad-spectrum antibiotic, given approximately 30 min before percutaneous endoscopic gastrostomy is effective in reducing the incidence of peristomal wound infections.