Free Content Impact of antibiotic prophylaxis on postbronchoscopy fever: a randomised controlled study

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Abstract:

BACKGROUND: Postbronchoscopy fever can develop in 5–16% of adult patients. The microbiological contribution to postbronchoscopy fever is unclear.

OBJECTIVE: To elucidate the effect of prophylactic antibiotics on the development of postbronchoscopy fever and pneumonia.

DESIGN: Study patients were randomised to receive no treatment or oral amoxicillin/clavulanate 30 min before flexible bronchoscopy. The primary outcome variable was the frequency of postbronchoscopy fever and pneumonia. White blood cell counts, C-reactive protein and the serum pyrogenic cytokines interleukin (IL) 1β, IL-6 and tumour necrosis factor-alpha were measured before and after bronchoscopy.

RESULTS: Of 143 subjects enrolled in the study, the final analysis was performed among 67 subjects in the prophylaxis group and 64 in the control group. The frequency of postbronchoscopy fever did not differ between the groups (25.4% for the prophylaxis group vs. 26.6% for controls, P > 0.05). Pneumonia developed in 1.5% of the prophylaxis group and 4.7% of the controls. There was no bacteraemia in either group. Serum pyrogenic cytokines did not differ between the groups.

CONCLUSIONS: Prophylactic antibiotics before bronchoscopy did not reduce the frequency of postbronchoscopy fever and did not affect serum levels of pyrogenic cytokines. These findings suggest that microbiological factors may not be responsible for the development of postbronchoscopy fever.

Keywords: antibiotic prophylaxis; bronchoscopy; cytokines; fever; pneumonia

Document Type: Regular Paper

DOI: http://dx.doi.org/10.5588/ijtld.10.0386

Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea 2: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea 3: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea

Publication date: April 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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