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Abstract：
To determine if ending the practice of administering prophylactic antibiotics prior to the placement of totally implantable venous access devices (TIVADs) is correlated with an increase in 30-day bloodstream infection-related TIVADs removals.
The practice of administering prophylactic antibiotics prior to the placement of TIVADs ended in July 2013 at our institution. We compiled a list of patients who had TIVADs placed between July 2010 and July 2016 and cross-referenced this list to a list of patients who had TIVADs removed between July 2010 and August 2016 to evaluate the 30-day bloodstream infection-related TIVAD removals. Retrospective chart review of all patients was performed to collect demographic information, indication for placement, and type of antibiotic administered, if applicable.
Over the study period of 6 years, a total of 1,513 TIVADs were placed, of which 28 cases were excluded because of death within 30 days unrelated to TIVAD placement. Of the remaining 1,485 cases, 733 TIVADs were placed in 709 unique patients with prophylactic antibiotic treatment and 752 TIVADs were placed in 709 unique patients without treatment. A total of 8 patients were identified to have TIVADs removed within 30 days owing to infection, of which 4 patients were treated with prophylactic antibiotics. The odds of infection-related removals without prophylactic treatment compared with prophylactic treatment was 0.97 (95% confidence interval, 0.24-3.91; P = .97).
Ending the practice of administrating systemic antibiotic prophylaxis prior to the placement of TIVADs had no effect on the 30-day bloodstream infection-related TIVAD removals rate at our institution. We do not recommend the use of prophylactic antibiotics for the placement of TIVAD.
The practice of administering prophylactic antibiotics prior to the placement of TIVADs ended in July 2013 at our institution. We compiled a list of patients who had TIVADs placed between July 2010 and July 2016 and cross-referenced this list to a list of patients who had TIVADs removed between July 2010 and August 2016 to evaluate the 30-day bloodstream infection-related TIVAD removals. Retrospective chart review of all patients was performed to collect demographic information, indication for placement, and type of antibiotic administered, if applicable.
Over the study period of 6 years, a total of 1,513 TIVADs were placed, of which 28 cases were excluded because of death within 30 days unrelated to TIVAD placement. Of the remaining 1,485 cases, 733 TIVADs were placed in 709 unique patients with prophylactic antibiotic treatment and 752 TIVADs were placed in 709 unique patients without treatment. A total of 8 patients were identified to have TIVADs removed within 30 days owing to infection, of which 4 patients were treated with prophylactic antibiotics. The odds of infection-related removals without prophylactic treatment compared with prophylactic treatment was 0.97 (95% confidence interval, 0.24-3.91; P = .97).
Ending the practice of administrating systemic antibiotic prophylaxis prior to the placement of TIVADs had no effect on the 30-day bloodstream infection-related TIVAD removals rate at our institution. We do not recommend the use of prophylactic antibiotics for the placement of TIVAD.
摘要：
为了确定在放置完全植入式静脉接入装置（TIVAD）之前终止预防性抗生素的使用是否与30天血流感染相关的TIVAD清除量的增加相关。
在我们的机构于2013年7月结束了在放置TIVADs之前施用预防性抗生素的实践。我们编制了一份在2010年7月至2016年7月期间放置TIVAD的患者名单，并将该名单与2010年7月至2016年8月期间移除TIVAD的患者名单交叉引用，以评估30天血流感染相关的TIVAD移除。对所有患者进行回顾性图表回顾以收集人口统计信息，放置指示，以及使用的抗生素类型，如果适用。
在6年的研究期间，总共放置了1,513个TIVAD，其中28例因与TIVAD放置无关的30天内死亡而被排除.在剩下的1485个案例中,在709例接受预防性抗生素治疗的独特患者中放置了733个TIVAD，在709例未经治疗的独特患者中放置了752个TIVAD。共有8名患者因感染在30天内被切除了TIVAD，其中4例患者接受预防性抗生素治疗。与预防性治疗相比，没有预防性治疗的感染相关清除的几率为0.97(95%置信区间，0.24-3.91；P=.97）。
在我们机构中，在放置TIVAD之前结束全身抗生素预防的做法对30天血流感染相关的TIVAD清除率没有影响。我们不建议使用预防性抗生素来放置TIVAD。
在我们的机构于2013年7月结束了在放置TIVADs之前施用预防性抗生素的实践。我们编制了一份在2010年7月至2016年7月期间放置TIVAD的患者名单，并将该名单与2010年7月至2016年8月期间移除TIVAD的患者名单交叉引用，以评估30天血流感染相关的TIVAD移除。对所有患者进行回顾性图表回顾以收集人口统计信息，放置指示，以及使用的抗生素类型，如果适用。
在6年的研究期间，总共放置了1,513个TIVAD，其中28例因与TIVAD放置无关的30天内死亡而被排除.在剩下的1485个案例中,在709例接受预防性抗生素治疗的独特患者中放置了733个TIVAD，在709例未经治疗的独特患者中放置了752个TIVAD。共有8名患者因感染在30天内被切除了TIVAD，其中4例患者接受预防性抗生素治疗。与预防性治疗相比，没有预防性治疗的感染相关清除的几率为0.97(95%置信区间，0.24-3.91；P=.97）。
在我们机构中，在放置TIVAD之前结束全身抗生素预防的做法对30天血流感染相关的TIVAD清除率没有影响。我们不建议使用预防性抗生素来放置TIVAD。
