Antibiotic prophylaxis to prevent complications in endoscopic retrograde cholangiopancreatography: A systematic review and meta-analysis of randomized controlled trials
Maria Fernanda Shinin Merchan, Diogo Turiani Hourneaux de Moura, Guilherme Henrique Peixoto de Oliveira, Ígor Mendonça Proença, Epifânio Silvino do Monte, Edson Ide, Caroline Moll, Sergio A. Sánchez‐Luna, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
Abstract
BACKGROUND: The prophylactic use of antibiotics in endoscopic retrograde cholangiopancreatography (ERCP) is still controversial. AIM: To assess whether antibiotic prophylaxis reduces the rates of complications in patients undergoing elective ERCP. METHODS: This systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A comprehensive search of multiple electronic databases was performed. Only randomized controlled trials were included. The outcomes analyzed included bacteremia, cholangitis, sepsis, pancreatitis, and mortality. The risk of bias was assessed by the Cochrane revised Risk-of-Bias tool for randomized controlled trials. The quality of evidence was assessed by the Grading of Recommendation Assessment, Development, and Evaluation. Meta-analysis was performed using the Review Manager 5.4 software. RESULTS: = 0.03). CONCLUSION: The prophylactic use of antibiotics in patients undergoing elective ERCP reduces the risk of bacteremia but does not appear to have an impact on the rates of cholangitis, septicemia, pancreatitis, and mortality.