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Endoscopic retrograde cholangiopancreatography (ERCP) can be complicated by procedure-related infections. Current guidelines recommend antibiotic prophylaxis only in patients with biliary obstruction in whom incomplete drainage is expected, but this can be difficult to predict. Should all patients who receive ERCP also get antibiotics to prevent infectious complications?
In a new meta-analysis, researchers included 2100 patients (mean age,64) from 11 randomized trials who underwent ERCP, mostly for biliary obstruction as evidenced by receipt of sphincterotomy, stenting, or both. Patients who were randomized to antibiotics most commonly received cephalosporins (56%), and most of these patients received one dose of antibiotic.