Association between prophylactic antibiotic use for transarterial chemoembolization and occurrence of liver abscess: A retrospective cohort study.

Abstract

OBJECTIVES\nClinical evidence on prophylactic antibiotics for transarterial chemoembolization (TACE) to prevent liver abscess is limited because liver abscess is a rare event. This study aimed to analyse the association between prophylactic antibiotic use for TACE and the occurrence of liver abscess after TACE.\n\n\nMETHODS\nUsing the nationwide Diagnosis Procedure Combination database in Japan, we retrospectively identified patients who underwent TACE for hepatic cancer between July 2010 and March 2017. The primary outcome was liver abscess requiring procedural intervention within 30\xa0days of TACE. Secondary outcomes included 30-day in-hospital mortality and length of stay. Propensity score matching was performed to adjust for potential confounding factors and compare outcomes between patients with and without prophylactic antibiotics.\n\n\nRESULTS\nAmong 167,544 eligible patients, 134,712 received antibiotics and 32,832 did not. In the matched cohort of 29,211 pairs, the proportion of patients with liver abscess requiring procedural intervention was significantly lower in the antibiotics group than in the non-antibiotics group (0.08% vs 0.22%, p = 0.001; relative risk, 0.35 [95% confidence interval, 0.22-0.57]; absolute risk reduction, 0.0014 [0.0008-0.0021]; number needed to treat, 696 [476-1,223]). There was no significant difference in 30-day in-hospital mortality between the groups. The length of stay was longer in the antibiotics group than in the non-antibiotics group (median, 10\xa0days vs 9\xa0days, p < 0.001).\n\n\nCONCLUSIONS\nProphylactic antibiotic use in patients undergoing TACE was associated with a reduced occurrence of liver abscess requiring procedural intervention.