Prophylactic antibiotics cut risk of infectious complications following transbronchial biopsy

For patients undergoing radial endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB), use of prophylactic antibiotics leads to a lower incidence of infectious complications in the presence of risk factors, according to a study.

Used for diagnosing peripheral lung lesions, rEBUS-TBB has been shown to lead to infectious complications. To evaluate the efficacy of short-term oral antibiotics for preventing such complications, researchers examined the medical records of 484 patients who underwent rEBUS-TBB, among whom 233 did not receive antibiotics for prophylaxis against infectious complications (no prophylactic group; n=233). The remaining 251 patients were given oral amoxicillin/clavulanate for 3 days (prophylactic group).

The cohort had a median age of 66 years (interquartile range, 59–74 years), and 58.9 percent of the patients were male. More than half of the population (54.4 percent) were previous or current smokers. In 63 patients (13 percent), a guide sheath was used to perform rEBUS-TBB.

Infectious complications occurred in only two patients who received prophylactic antibiotics. This was fewer than the 12 patients (5.2 percent) identified in the no prophylactic group.

Multivariable logistic regression analysis revealed infectious complications to be significantly associated with a cavity or low-density attenuation of the lesion and with obstructive pneumonic consolidation, but not with prophylactic antibiotics.

Subgroup analysis showed that infectious complications were less likely to occur when prophylactic antibiotics were used in patients with at least one risk factor (p=0.005).