Efficacy of Antibiotic Prophylaxis after Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Preliminary Prospective Study

Abstract

Introduction Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful modality in the pathological diagnosis of hilar and mediastinal lymphadenopathy caused by lung cancer [1-3], sarcoidosis [4], malignant lymphoma [5,6], and other diseases [7,8]. Recent reports indicate that the diagnostic sensitivity and accuracy of mediastinal lymph nodes in the staging of lung cancer by EBUS-TBNA were similar to the sensitivity and accuracy of mediastinoscopy, and the number of complications was fewer with EBUS-TBNA than with mediastinoscopy [9]. Another group of investigators showed that the diagnostic sensitivity of EBUS-TBNA for metastatic lymphadenopathy of lung cancer was higher than the sensitivity of positron emission tomography [10]. Moreover, the quality of samples from lymph nodes (LNs) obtained by EBUS-TBNA was sufficient for molecular testing, which included epidermal growth factor receptor mutation and the anaplastic lymphoma kinase fusion gene in lung cancer [11-13]. Although EBUS-TBNA is a relatively tolerable and safe procedure [14], infectious complications after EBUS-TBNA have been reported including mediastinitis, pneumonia, and pericarditis [15]. Infectious complications induced by EBUS-TBNA are often more serious than infections associated with conventional fiberoptic bronchoscopy, and precautions should be considered to prevent these infectious events. Whereas prior studies have not indicated the usefulness of antibiotics prophylaxis after conventional fiberoptic bronchoscopy, the efficacy of antibiotic prophylaxis especially after EBUS-TBNA remains unclear. Thus, the objective of this study was to evaluate the effect of antibiotic prophylaxis in preventing the frequency of postbronchoscopy fever and infectious complications after EBUS-TBNA, preliminarily. Abstract Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is useful for diagnosing mediastinal and hilar lymphadenopathy. While bacteremia and serious infectious complications after EBUS-TBNA have been reported, the efficacy of antibiotic prophylaxis is unclear. This preliminary prospective study aimed to evaluate the efficacy of antibiotic prophylaxis after EBUS-TBNA.