Prophylactic Antibiotic Use Prior to Port Placement and Its Effect on Insertion-Related Infection Rates: A Five-Year Retrospective Review

Abstract

Purpose The aim of this study was to compare insertion-related port infection rates between patients who received intraprocedural prophylactic antibiotics versus those who did not. Materials and Methods All patients who underwent port insertion by interventional radiology from 7/1/ 2015 through 7/1/2020 at a single U.S.-based Health System were identified using electronic medical records database. During this period, 2,099 patients underwent port placement at three hospitals within the same health system. One-thousand sixty-three patients who underwent port placement at one hospital received periprocedural antibiotics and 1,036 patients at the two other hospitals did not receive antibiotics. Retrospective data were reviewed on each patient including demographics, reason for port insertion, and evidence of port infection. All relevant data up to 30 days postinsertion were reviewed, including blood cultures, unplanned readmissions, emergency room visits, and clinic visits. Qualitative trends were evaluated for various subgroups including presence of bacteremia, time from insertion, and demographics. Patients with an obvious external source of infection were excluded. Results Insertion-related infection rate was 0.9% for the entire cohort, 1.23% for the antibiotic group, and 0.68% for the nonantibiotic group. The insertion-related infection for adult patients was 0.88% for the antibiotic group and 0.68% for the nonantibiotic group. The pediatric insertion-related infection rate was 7.69%, all of whom received intravenous antibiotics. No other clear qualitative differences were noted for analyzed subgroups. Conclusion This study demonstrates low insertion-related port infection rate with no clinically significant difference between the groups that did or did not receive antibiotics. Subgroup analysis showed an exceptionally high infection rate in the pediatric population despite receiving preprocedure antibiotics.