Antibiotic prophylaxis to prevent complications in endoscopic retrograde cholangiopancreatography: A systematic review and meta-analysis of randomized controlled trials

doi:10.4253/wjge.v14.i11.718

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Endosc. Nov 16, 2022; 14(11): 718-730
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.718

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, Igor Mendonça Proença, Epifanio Silvino do Monte Junior, Edson Ide, Caroline Moll, Sergio A Sánchez-Luna, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura

Maria Fernanda Shinin Merchan, Diogo Turiani Hourneaux de Moura, Guilherme Henrique Peixoto de Oliveira, Igor Mendonça Proença, Epifanio Silvino do Monte Junior, Edson Ide, Caroline Moll, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil

Sergio A Sánchez-Luna, Department of Internal Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, United States

Author contributions: Merchan MFS contributed to acquisition of data, analysis, interpretation of data, drafting the article, revising the article, and final approval; de Moura DTH, de Oliveira GHP, Proença IM, Monte ES, Ide E, and Moll CF contributed to analysis and interpretation of data and revising the article; Sánchez-Luna SA contributed to interpretation of data, drafting the article, revising the article, and final approval; Bernardo WM contributed to analysis of data, interpretation of data, drafting the article, revising the article, and final approval; de Moura EGH contributed to analysis and interpretation of data, drafting the article, revising the article, and final approval.

Conflict-of-interest statement: Diogo Turiani Hourneaux de Moura: BariaTek – Advisory Board Member (Consulting fees); Sergio A Sánchez-Luna: Recipient of the 2021 American Society for Gastrointestinal Endoscopy (ASGE) Endoscopic Training Award by the ASGE and Fujifilm; Eduardo Guimarães Hourneaux de Moura: Olympus – Consultant (Consulting fees), Boston Scientific – Consultant (Consulting fees); and other authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: All the authors in this manuscript have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Guilherme Henrique Peixoto de Oliveira, MD, Medical Assistant, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar, 225, São Paulo 05403-010, Brazil. guilherme.hpoliveira@hc.fm.usp.br

Received: May 27, 2022
Peer-review started: May 27, 2022
First decision: June 9, 2022
Revised: June 22, 2022
Accepted: October 26, 2022
Article in press: October 26, 2022
Published online: November 16, 2022

Core Tip

Core Tip: There is controversy about antibiotic prophylaxis in patients undergoing elective endoscopic retrograde cholangiopancreatography. This is a systematic review and meta-analysis based on randomized controlled trials that analyzed whether the use of antibiotic prophylaxis is beneficial in preventing complications after this procedure. Outcomes evaluated include the rate of cholangitis, bacteremia, sepsis, pancreatitis, and mortality. Based on this meta-analysis, antibiotic prophylaxis reduces the risk of bacteremia but does not impact the rate of cholangitis, septicemia, pancreatitis, and mortality.