Perioperative antibiotics should be used for placement of implanted central venous ports: A propensity analysis evaluating risk

To quantify risk for CRI based on PABX use in CVAP placement for cancer patients. : Central venous access ports (CVAP) are totally implanted devices used for chemotherapy. There is a temporal risk for catheter related infection (CRI) to insertion and perioperative prophylactic antibiotics (PABX) use is a contested issue among practitioners. Data was collected from a single center, academic oncology center. Treatment with a perioperative PABX was compared to non-treatment, to examine the incidence of 14-day CRI. Propensity scores with matched weights controlled for confounding, using 15 demographic, procedural and clinical variables. From 2007 to 2012, 1,091 CVAP were placed, where 59.7 % received PABX. The 14-day CRI rate was 0.82%, with 78% of those not receiving PABX. While results did not achieve statistical significance, use of PABX was associated with a 58% reduction in the odds of a 14-day CRI (OR = 0.42, 95% CI: 0.08-2.24, p = 0.31). The findings suggest a reduction in early CRI with the use of PABX. Since CRI treatment can range from a course of oral antibiotics, port removal, to hospital admission, we suggest clinicians consider these data when considering PABX in this high-risk population. In a cohort of cancer patients to receive chemotherapy, 1,091 CVAP were placed in which 59.7% received preoperative intravenous prophylactic antibiotics (PABX). A propensity analysis was done that controlled for 15 demographic, clinical, and procedural variables, that revealed a 58%, reduction in the odds of 14-day CRI (OR=0.42, 95% CI: 0.08-2.24, p=0.31) for those given PABX. Although not statistically significant, the clinical implications of protection provided by PABX should not be overlooked.