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BACKGROUND:Percutaneous endoscopic gastrostomies (PEG) maintain nutrition in the short orlong term. A PEG is a feeding tube, placed surgically through the anteriorabdominal wall, which delivers a liquid diet, or medication, via a clean orsterile delivery system. Those undergoing PEG placement are often vulnerable toinfection because of age, compromised nutritional intake, immunosuppression andunderlying disease processes such as malignancy and diabetes mellitus. Theincreasing incidence of methicillin-resistant Staphylococcus aureus (MRSA)contributes both an additional risk to the placement procedure, and also to thedebate surrounding antibiotic prophylaxis for PEG placement. The aim ofsurgical antimicrobial prophylaxis is to establish a bactericidal concentrationof an antimicrobial drug in the patients serum and tissues, via a brief courseof an appropriate agent, by the time of PEG placement. OBJECTIVES: The reviewseeks to establish whether prophylactic use of systemic antimicrobials reducesthe risk of peristomal infection in people undergoing placement of percutaneousendoscopic gastrostomies. SEARCH STRATEGY: We searched the Cochrane WoundsGroup Specialised Register (July 2006); The Cochrane Central Register ofControlled Trials (The Cochrane Library 2006, Issue 2); handsearched wound carejournals relevant conference proceedings, and bibliographies of relevantpublications identified by these strategies for further studies; and contactedmanufacturers and distributors of PEG products. SELECTION CRITERIA: Randomisedcontrolled trials (RCTs) evaluating the use of prophylactic antimicrobials forPEG placement, with no restrictions for language, date or publication status.DATA COLLECTION AND ANALYSIS: Both authors performed data extraction andassessment of study quality. Meta-analysis was performed where appropriate.MAIN RESULTS: We identified 10 eligible RCTs evaluating prophylacticantimicrobials in 1100 patients. All trials reported peristomal infection as anoutcome, and a pooled analysis resulted in a statistically significantreduction in the incidence of peristomal infection with prophylacticantibiotics (pooled OR 0.31, 95% CI 0.22 to 0.44). AUTHORS' CONCLUSIONS:Administration of systemic prophylactic antibiotics for PEG placement reducesperistomal infection.Leggil'articolo