Addition of gentamicin to endoscopic retrograde cholangiopancreatography (ERCP) contrast medium towards reducing the frequency of septic complications of ERCP

Journal of Digestive Diseases
Francisco C RamirezKaren L Woods

Abstract

Bacteremia and sepsis are serious complications of endoscopic retrograde cholangiopancreatography (ERCP) and occur in between 0.5 and 3% of cases. Patients with obstructed bile ducts are at highest risk of developing septic complications. The purpose of this investigation was to determine whether the addition of gentamicin to the ERCP contrast medium prevents or reduces the growth of Pseudomonas aeruginosa in vitro. Artificial bile ducts were fashioned out of dialysis tubing and suspended in flasks containing brain heart infusion (BHI) broth. The tubing contained BHI broth alone, with or without contrast medium or with contrast medium plus gentamicin. The artificial ducts were inoculated with gentamicin-sensitive or gentamicin-resistant P. aeruginosa and quantitative cultures were performed. The contrast medium alone was bacteriostatic to both sensitive and resistant P. aeruginosa isolates. The addition of gentamicin to the contrast medium eliminated the sensitive strain after 2 h and resulted in a reduction in the number of gentamicin-resistant P. aeruginosa after 4 h. Incubation of the resistant isolate in the presence of contrast and gentamicin for an additional 4 h led to a further reduction in viable bacteria but did not c...Continue Reading

Citations

Oct 20, 2012·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Alireza NorouziRasoul Sotoudehmanesh
Nov 18, 2004·AJR. American Journal of Roentgenology·Alfonso RagozzinoMassimo Imbriaco
Apr 25, 2014·Avicenna Journal of Medicine·Hadoun JabriNkemakolam Iroegbu

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