Semin intervent Radiol 2005; 22(2): 69-79
DOI: 10.1055/s-2005-871861
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

A Guide to Antibiotics for the Interventional Radiologist

Ali Zarrinpar1 , Robert K. Kerlan1  Jr. 
  • 1Department of Radiology, University of California, San Francisco
Further Information

Publication History

Publication Date:
28 June 2005 (online)

ABSTRACT

Antibiotics are among the most common pharmaceutical agents used by the interventional radiologist. This article updates some of the practical aspects of the use of antibiotics in interventional radiological practice and provides some general guidelines with respect to indications for and selection of antibiotics. In particular, the objectives of this article are to review the basic pharmacology of the common antibiotic agents, the interventional radiological procedures in which prophylactic antibiotics are usually administered, the specific antimicrobial agents recommended for prophylaxis before common interventional radiological procedures, the appropriate antibiotics for patients allergic to penicillins, and the indications for antibiotic prophylaxis to prevent bacterial endocarditis.

REFERENCES

  • 1 Dravid V S, Gupta A, Zegel H G, Morales A V, Rabinowitz B, Freiman D B. Investigation of antibiotic prophylaxis usage for vascular and nonvascular interventional procedures.  J Vasc Interv Radiol. 1998;  9 401-406
  • 2 Ghosal S, Taylor C J. Intravenous desensitization to ceftazidime in cystic fibrosis patients.  J Antimicrob Chemother. 1997;  39 556-557
  • 3 Papakonstantinou G, Bogner J R, Hofmeister F, Hehlmann R. Cefotaxime desensitization.  Clin Investig. 1993;  71 165-167
  • 4 Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC).  MMWR Recomm Rep. 1995;  44(RR-12) 1-13
  • 5 Enright M C. The evolution of a resistant pathogen: the case of MRSA.  Curr Opin Pharmacol. 2003;  3 474-479
  • 6 Eliopoulos G M. Current and new antimicrobial agents.  Am Heart J. 2004;  147 587-592
  • 7 Diekema D J, Jones R N. Oxazolidinone antibiotics.  Lancet. 2001;  358 1975-1982
  • 8 Streit J M, Jones R N, Sader H S. Daptomycin activity and spectrum: a worldwide sample of 6737 clinical Gram-positive organisms.  J Antimicrob Chemother. 2004;  53 669-674
  • 9 De Gaudio A R, Di Filippo A. What is the role of streptogramins in intensive care?.  J Chemother. 2003;  15(suppl 3) 17-21
  • 10 Spies J B, Rosen R J, Lebowitz A S. Antibiotic prophylaxis in vascular and interventional radiology: a rational approach.  Radiology. 1988;  166 381-387
  • 11 McDermott V G, Schuster M G, Smith T P. Antibiotic prophylaxis in vascular and interventional radiology.  AJR Am J Roentgenol. 1997;  169 31-38
  • 12 Berard F, Gandon J. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors.  Ann Surg. 1964;  160(suppl 1) 1-192
  • 13 Kaye K S, Fraimow H S, Abrutyn E. Pathogens resistant to antimicrobial agents. Epidemiology, molecular mechanisms, and clinical management.  Infect Dis Clin North Am. 2000;  14 293-319
  • 14 Chavers L S, Moser S A, Funkhouser E et al.. Association between antecedent intravenous antimicrobial exposure and isolation of vancomycin-resistant enterococci.  Microb Drug Resist. 2003;  9(suppl 1) S69-S77
  • 15 Esposito S, Capuano A, Noviello S et al.. Modification of patients' endogenous bacterial flora during hospitalization in a large teaching hospital in Naples.  J Chemother. 2003;  15 568-573
  • 16 Cronan J J, Horn D L, Marcello A et al.. Antibiotics and nephrostomy tube care: preliminary observations. Part II. Bacteremia.  Radiology. 1989;  172 1043-1045
  • 17 Christiano A P, Hollowell C M, Kim H et al.. Double-blind randomized comparison of single-dose ciprofloxacin versus intravenous cefazolin in patients undergoing outpatient endourologic surgery.  Urology. 2000;  55 182-185
  • 18 Clark C D, Picus D, Dunagan W C. Bloodstream infections after interventional procedures in the biliary tract.  Radiology. 1994;  191 495-499
  • 19 Brody L A, Brown K T, Getrajdman G I et al.. Clinical factors associated with positive bile cultures during primary percutaneous biliary drainage.  J Vasc Interv Radiol. 1998;  9 572-578
  • 20 Davis A J, Kolios G, Alveyn C G, Robertson D A. Antibiotic prophylaxis for ERCP: a comparison of oral ciprofloxacin with intravenous cephazolin in the prophylaxis of high-risk patients.  Aliment Pharmacol Ther. 1998;  12 207-211
  • 21 Raty S, Sand J, Pulkkinen M, Matikainen M, Nordback I. Post-ERCP pancreatitis: reduction by routine antibiotics.  J Gastrointest Surg. 2001;  5 339-345 , discussion 45
  • 22 Thompson B F, Arguedas M R, Wilcox C M. Antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice: is it worth the cost?.  Aliment Pharmacol Ther. 2002;  16 727-734
  • 23 Leung J W, Libby E D, Morck D W et al.. Is prophylactic ciprofloxacin effective in delaying biliary stent blockage?.  Gastrointest Endosc. 2000;  52 175-182
  • 24 Lai E C, Lo C M, Choi T K, Cheng W K, Fan S T, Wong J. Urgent biliary decompression after endoscopic retrograde cholangiopancreatography.  Am J Surg. 1989;  157 121-125
  • 25 Ryan J M, Ryan B M, Smith T P. Antibiotic prophylaxis in interventional radiology.  J Vasc Interv Radiol. 2004;  15 547-556
  • 26 Dormann A J, Wigginghaus B, Risius H et al.. Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): results from a prospective randomized multicenter trial.  Z Gastroenterol. 2000;  38 229-234
  • 27 Dormann A J, Wigginghaus B, Risius H et al.. A single dose of ceftriaxone administered 30 minutes before percutaneous endoscopic gastrostomy significantly reduces local and systemic infective complications.  Am J Gastroenterol. 1999;  94 3220-3224
  • 28 Ahmad I, Mouncher A, Abdoolah A et al.. Antibiotic prophylaxis for percutaneous endoscopic gastrostomy: a prospective, randomised, double-blind trial.  Aliment Pharmacol Ther. 2003;  18 209-215
  • 29 Sharma V K, Howden C W. Meta-analysis of randomized, controlled trials of antibiotic prophylaxis before percutaneous endoscopic gastrostomy.  Am J Gastroenterol. 2000;  95 3133-3136
  • 30 Deibert P, Schwarz S, Olschewski M, Siegerstetter V, Blum H E, Rossle M. Risk factors and prevention of early infection after implantation or revision of transjugular intrahepatic portosystemic shunts: results of a randomized study.  Dig Dis Sci. 1998;  43 1708-1713
  • 31 Reed R A, Teitelbaum G P, Daniels J R, Pentecost M J, Katz M D. Prevalence of infection following hepatic chemoembolization with cross-linked collagen with administration of prophylactic antibiotics.  J Vasc Interv Radiol. 1994;  5 367-371
  • 32 Geschwind J F, Kaushik S, Ramsey D E, Choti M A, Fishman E K, Kobeiter H. Influence of a new prophylactic antibiotic therapy on the incidence of liver abscesses after chemoembolization treatment of liver tumors.  J Vasc Interv Radiol. 2002;  13 1163-1166
  • 33 Siskin G P, Stainken B F, Dowling K, Meo P, Ahn J, Dolen E G. Outpatient uterine artery embolization for symptomatic uterine fibroids: experience in 49 patients.  J Vasc Interv Radiol. 2000;  11 305-311
  • 34 Ryan J M, Gainey M, Glasson J, Doherty J, Smith T P. Simplified pain protocol after uterine artery embolization.  Radiology. 2002;  224 610-612
  • 35 Pron G, Bennett J, Common A et al.. Technical results and effects of operator experience on uterine artery embolization for fibroids: the Ontario Uterine Fibroid Embolization Trial. The Ontario UFE Collaborative Group.  J Vasc Interv Radiol. 2003;  14 545-554
  • 36 Mehta H, Sandhu C, Matson M, Belli A-M. Review of re-admissions due to complications from uterine fibroid embolization.  Clin Radiol. 2002;  57 1122-1124
  • 37 O'Grady N P, Alexander M, Dellinger E P et al.. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.  MMWR Recomm Rep. 2002;  51(RR-10) 1-29
  • 38 Vassilomanolakis M, Plataniotis G, Koumakis G et al.. Central venous catheter-related infections after bone marrow transplantation in patients with malignancies: a prospective study with short-course vancomycin prophylaxis.  Bone Marrow Transplant. 1995;  15 77-80
  • 39 Lim S H, Smith M P, Machin S J, Goldstone A H. Prophylactic teicoplanin during insertion of Hickman catheters.  Br J Haematol. 1990;  76(suppl 2) 27-29
  • 40 Al-Sibai M B, Harder E J, Faskin R W, Johnson G W, Padmos M A. The value of prophylactic antibiotics during the insertion of long-term indwelling silastic right atrial catheters in cancer patients.  Cancer. 1987;  60 1891-1895
  • 41 Bock S N, Lee R E, Fisher B et al.. A prospective randomized trial evaluating prophylactic antibiotics to prevent triple-lumen catheter-related sepsis in patients treated with immunotherapy.  J Clin Oncol. 1990;  8 161-169
  • 42 Shaul D B, Scheer B, Rokhsar S et al.. Risk factors for early infection of central venous catheters in pediatric patients.  J Am Coll Surg. 1998;  186 654-658
  • 43 Ranson M R, Oppenheim B A, Jackson A, Kamthan A G, Scarffe J H. Double-blind placebo controlled study of vancomycin prophylaxis for central venous catheter insertion in cancer patients.  J Hosp Infect. 1990;  15 95-102
  • 44 McKee R, Dunsmuir R, Whitby M, Garden O J. Does antibiotic prophylaxis at the time of catheter insertion reduce the incidence of catheter-related sepsis in intravenous nutrition?.  J Hosp Infect. 1985;  6 419-425
  • 45 Ljungman P, Hagglund H, Bjorkstrand B, Lonnqvist B, Ringden O. Peroperative teicoplanin for prevention of gram-positive infections in neutropenic patients with indwelling central venous catheters: a randomized, controlled study.  Support Care Cancer. 1997;  5 485-488
  • 46 Lund G B, Trerotola S O, Scheel Jr P F et al.. Outcome of tunneled hemodialysis catheters placed by radiologists.  Radiology. 1996;  198 467-472
  • 47 Trerotola S O, Johnson M S, Harris V J et al.. Outcome of tunneled hemodialysis catheters placed via the right internal jugular vein by interventional radiologists.  Radiology. 1997;  203 489-495
  • 48 Simpson K R, Hovsepian D M, Picus D. Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements.  J Vasc Interv Radiol. 1997;  8 189-195
  • 49 Schwartz C, Henrickson K J, Roghmann K, Powell K. Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms.  J Clin Oncol. 1990;  8 1591-1597
  • 50 Henrickson K J, Axtell R A, Hoover S M et al.. Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: a randomized, multicenter, double-blind trial.  J Clin Oncol. 2000;  18 1269-1278
  • 51 Carratala J, Niubo J, Fernandez-Sevilla A et al.. Randomized, double-blind trial of an antibiotic-lock technique for prevention of gram-positive central venous catheter-related infection in neutropenic patients with cancer.  Antimicrob Agents Chemother. 1999;  43 2200-2204
  • 52 Raad I, Buzaid A, Rhyne J et al.. Minocycline and ethylenediaminetetraacetate for the prevention of recurrent vascular catheter infections.  Clin Infect Dis. 1997;  25 149-151
  • 53 Tcholakian R K, Raad I I. Durability of anti-infective effect of long-term silicone sheath catheters impregnated with antimicrobial agents.  Antimicrob Agents Chemother. 2001;  45 1990-1993
  • 54 Darouiche R O, Raad I I, Heard S O et al.. A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group.  N Engl J Med. 1999;  340 1-8
  • 55 Bunt T J, Gill H K, Smith D C, Taylor F C. Infection of a chronically implanted iliac artery stent.  Ann Vasc Surg. 1997;  11 529-532
  • 56 Paget D S, Bukhari R H, Zayyat E J, Lohr J M, Roberts W H, Welling R E. Infectibility of endovascular stents following antibiotic prophylaxis or after arterial wall incorporation.  Am J Surg. 1999;  178 219-224
  • 57 Becker G J, Kovacs M, Mathison M N et al.. Risk stratification and outcomes of transluminal endografting for abdominal aortic aneurysm: 7-year experience and long-term follow-up.  J Vasc Interv Radiol. 2001;  12 1033-1046
  • 58 Heikkinen L, Valtonen M, Lepantalo M, Saimanen E, Jarvinen A. Infrarenal endoluminal bifurcated infected stent with Listeria monocytogenes .  J Vasc Surg. 1999;  29 554-556
  • 59 Saxon A, Beall G N, Rohr A S, Adelman D C. Immediate hypersensitivity reactions to beta-lactam antibiotics.  Ann Intern Med. 1987;  107 204-215
  • 60 Dajani A S, Bisno A L, Chung K J et al.. Prevention of bacterial endocarditis. Recommendations by the American Heart Association.  JAMA. 1990;  264 2919-2922
  • 61 Dajani A S, Taubert K A, Wilson W et al.. Prevention of bacterial endocarditis. Recommendations by the American Heart Association.  JAMA. 1997;  277 1794-1801
  • 62 Apter A J, Kinman J L, Bilker W B et al.. Represcription of penicillin after allergic-like events.  J Allergy Clin Immunol. 2004;  113 764-770
  • 63 Robinson J L, Hameed T, Carr S. Practical aspects of choosing an antibiotic for patients with a reported allergy to an antibiotic.  Clin Infect Dis. 2002;  35 26-31
  • 64 Goodman E J, Morgan M J, Johnson P A, Nichols B A, Denk N, Gold B B. Cephalosporins can be given to penicillin-allergic patients who do not exhibit an anaphylactic response.  J Clin Anesth. 2001;  13 561-564
  • 65 Salkind A R, Cuddy P G, Foxworth J W. The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.  JAMA. 2001;  285 2498-2505

Robert K Kerlan JrM.D. 

Department of Radiology, M-361, University of California

San Francisco, 505 Parnassus, Box 0628

San Francisco, CA 94143

    >