Infection prophylaxis for PEG

Published: 2010-08-13

The deposition of co-trimoxazole solution into a newly inserted percutaneous endoscopic gastrostomy (PEG) tube is at least as effective at preventing wound infections as IV cefuroxime given prior to the procedure.

Infection is the most common acute complication associated with the insertion of a PEG catheter; insertion site infection occurring in around one third of patients. A single IV dose of cefuroxime one hour prior to the procedure is the current gold standard of antibiotic prophylaxis. The new technique is a cheaper and technically easier option for prophylaxis.

The authors note some trial limitations but the new strategy of antibiotic prophylaxis “can be administered rapidly and is inexpensive, safe, less likely to be administered needlessly [as they are given prior to the procedure, IV antibiotics are sometimes when PEG insertion is not performed] and could be used wherever the PEG procedure is done”.

1. BMJ. 2010;341:c3115