Antibiotic Prophylaxis for Enteryx™ Procedure: Preliminary Results

Abstract

Introduction: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorder. EnteryxTM (Boston Scientific Corporation, Natick, Massachussets, USA) is a recently FDA-approved procedure for endoscopic treatment of GERD. About 12% of patients treated by EnteryxTM, experience fever of unknown origin within 24h post byopolimer implantation. No data are available about antibiotic prophylaxis in these patients. The aim of this preliminary study is to investigate the prevalence of bacteremia after Enteryx injection. Methods: A cohort study, including all consecutive patients, admitted at our institute to perform EnteryxTM injection, was started on June 2004. For each patients we collected age, sex, white blood cells count, risk factors for bloodstream infections, co-morbidity and previous antibiotic therapy. All patients underwent two blood-cultures after EnteryxTM procedure when they became febrile. No antibiotics prophylaxis were given. Results: Six patients (4 males and 2 females, 42.6 median age, range 26-55), with PPIs-dependent GERD symptoms were enrolled. At admission no patients had signs or symptoms of infection in any site and none received antibiotic prophylaxis. One patient had a history of Helicobacter pylori gastritis eradicated one year before the study. Five patients (83%) became febrile (body temperature >99.5 F) within 24 hours of EnteryxTM injection. All blood-cultures were negative and none had leucocytosis. After one month of follow-up no patients were no sign or symptoms of infection. Conclusions: These preliminary data show that the development of fever after EnteryxTM injection is probably associated to the procedure itself and not to bacteremia. Further results are needed to confirm that antibiotic prophylaxis is not necessary for this procedure.