We have located links that may give you full text access.
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Is prophylactic ciprofloxacin effective in delaying biliary stent blockage?
Gastrointestinal Endoscopy 2000 August
BACKGROUND: Late stent blockage is a major complication of endoscopic stent insertion for malignant obstructive jaundice. Stents block as a result of bacterial infection and biofilm formation. We report a randomized but unblinded study using an animal model to evaluate the effect of prophylactic ciprofloxacin, which selectively suppresses gram-negative bacteria, in an attempt to prolong stent patency.
METHOD: Ten adult cats underwent surgical implantation of 5F polyethylene stents through common bile duct strictures created around the choledochotomy, with the tip of the stent left in the duodenum. Five animals received intravenous ciprofloxacin perioperatively and were then maintained on oral ciprofloxacin 25 mg twice daily. Control cats were not given antibiotics. The animals were sacrificed when signs of biliary obstruction or cholangitis persisted for more than 3 days or at the end of the 16-week study period. Stents were removed and examined for patency. In addition, the stents were cultured to recover the adherent bacteria.
RESULTS: All control animals developed stent blockage within 4 weeks. Two ciprofloxacin-treated cats developed stent blockage at 21 and 42 days, respectively, whereas the other 3 cats had patent stents for the entire study period. There was a significant difference between the median stent patency of 112 days for the ciprofloxacin group versus 16 days for the control group (p < 0.02). Bacteriologic cultures showed that the bile and blocked stents from the control group had predominantly gram-negative bacteria, whereas the bile and stents of the ciprofloxacin group had gram-positive and anaerobic bacteria, with an absence of gram-negative bacteria (p < 0.01).
CONCLUSION: Ciprofloxacin prophylaxis eliminates gram-negative bacterial infection in bile and minimizes sludge formation and may have a potential benefit in delaying stent blockage.
METHOD: Ten adult cats underwent surgical implantation of 5F polyethylene stents through common bile duct strictures created around the choledochotomy, with the tip of the stent left in the duodenum. Five animals received intravenous ciprofloxacin perioperatively and were then maintained on oral ciprofloxacin 25 mg twice daily. Control cats were not given antibiotics. The animals were sacrificed when signs of biliary obstruction or cholangitis persisted for more than 3 days or at the end of the 16-week study period. Stents were removed and examined for patency. In addition, the stents were cultured to recover the adherent bacteria.
RESULTS: All control animals developed stent blockage within 4 weeks. Two ciprofloxacin-treated cats developed stent blockage at 21 and 42 days, respectively, whereas the other 3 cats had patent stents for the entire study period. There was a significant difference between the median stent patency of 112 days for the ciprofloxacin group versus 16 days for the control group (p < 0.02). Bacteriologic cultures showed that the bile and blocked stents from the control group had predominantly gram-negative bacteria, whereas the bile and stents of the ciprofloxacin group had gram-positive and anaerobic bacteria, with an absence of gram-negative bacteria (p < 0.01).
CONCLUSION: Ciprofloxacin prophylaxis eliminates gram-negative bacterial infection in bile and minimizes sludge formation and may have a potential benefit in delaying stent blockage.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app