The role of ciprofloxacin in prolonging polyethylene biliary stent patency: A multicenter, double-blinded effectiveness study

Gabriel Chan, Jeffrey Barkun, Alan N. Barkun, Eric Valois, Albert Cohen, Gad Friedman, Jose Parent, Jonathan Love, Robert Enns, Vicky Baffis, Mansour Jabbari, Peter Szego, Larry Stein, Neena Susan Abraham

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Plastic stents are the mainstay of the palliation of malignant jaundice but are complicated by recurrent obstruction. Previous trials have failed to demonstrate any improvement in patency with the use of antibiotics. Patients with malignant jaundice were randomized in a double-blind fashion, after polyethylene stent insertion, to receive ciprofloxacin or placebo. After successful stent decompression, there were 50 patients in the treatment arm and 44 in the placebo. There were 14 (33%) episodes of stent occlusion in the ciprofloxacin group versus 23 (49%) in placebo (χ2 test, P = 0.115). There was no significant difference in patency (log-rank test, P = 0.17). There were significantly fewer episodes of cholangitis with ciprofloxacin: 10 (23%) versus 21 (42%) in the placebo (P = 0.047). The ciprofloxacin group also demonstrated a significant improvement in the Social Function domain of the SF-36 Quality of Life Survey at 1 month (paired T test, P = 0.03). The other domains of the SF-36 were not different, nor was survival (log rank, P = 0.80). There is insufficient evidence to show that prophylactic ciprofloxacin can prolong plastic biliary stent patency. The observed trends suggest that ciprofloxacin significantly decreases the incidence of cholangitis and results in improvements in certain aspects of quality of life.

Original languageEnglish (US)
Pages (from-to)481-488
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume9
Issue number4
DOIs
StatePublished - Apr 1 2005
Externally publishedYes

Fingerprint

Polyethylene
Ciprofloxacin
Stents
Placebos
Cholangitis
Jaundice
Plastics
Quality of Life
Decompression
Anti-Bacterial Agents
Survival
Incidence

Keywords

  • Biliary
  • Ciprofloxacin
  • Obstructive jaundice
  • Quality of life
  • Stents

ASJC Scopus subject areas

  • Surgery

Cite this

The role of ciprofloxacin in prolonging polyethylene biliary stent patency : A multicenter, double-blinded effectiveness study. / Chan, Gabriel; Barkun, Jeffrey; Barkun, Alan N.; Valois, Eric; Cohen, Albert; Friedman, Gad; Parent, Jose; Love, Jonathan; Enns, Robert; Baffis, Vicky; Jabbari, Mansour; Szego, Peter; Stein, Larry; Abraham, Neena Susan.

In: Journal of Gastrointestinal Surgery, Vol. 9, No. 4, 01.04.2005, p. 481-488.

Research output: Contribution to journalArticle

Chan, G, Barkun, J, Barkun, AN, Valois, E, Cohen, A, Friedman, G, Parent, J, Love, J, Enns, R, Baffis, V, Jabbari, M, Szego, P, Stein, L & Abraham, NS 2005, 'The role of ciprofloxacin in prolonging polyethylene biliary stent patency: A multicenter, double-blinded effectiveness study', Journal of Gastrointestinal Surgery, vol. 9, no. 4, pp. 481-488. https://doi.org/10.1016/j.gassur.2004.10.008
Chan, Gabriel ; Barkun, Jeffrey ; Barkun, Alan N. ; Valois, Eric ; Cohen, Albert ; Friedman, Gad ; Parent, Jose ; Love, Jonathan ; Enns, Robert ; Baffis, Vicky ; Jabbari, Mansour ; Szego, Peter ; Stein, Larry ; Abraham, Neena Susan. / The role of ciprofloxacin in prolonging polyethylene biliary stent patency : A multicenter, double-blinded effectiveness study. In: Journal of Gastrointestinal Surgery. 2005 ; Vol. 9, No. 4. pp. 481-488.
@article{a6955e85eb8f43409169ca5b2bf19111,
title = "The role of ciprofloxacin in prolonging polyethylene biliary stent patency: A multicenter, double-blinded effectiveness study",
abstract = "Plastic stents are the mainstay of the palliation of malignant jaundice but are complicated by recurrent obstruction. Previous trials have failed to demonstrate any improvement in patency with the use of antibiotics. Patients with malignant jaundice were randomized in a double-blind fashion, after polyethylene stent insertion, to receive ciprofloxacin or placebo. After successful stent decompression, there were 50 patients in the treatment arm and 44 in the placebo. There were 14 (33{\%}) episodes of stent occlusion in the ciprofloxacin group versus 23 (49{\%}) in placebo (χ2 test, P = 0.115). There was no significant difference in patency (log-rank test, P = 0.17). There were significantly fewer episodes of cholangitis with ciprofloxacin: 10 (23{\%}) versus 21 (42{\%}) in the placebo (P = 0.047). The ciprofloxacin group also demonstrated a significant improvement in the Social Function domain of the SF-36 Quality of Life Survey at 1 month (paired T test, P = 0.03). The other domains of the SF-36 were not different, nor was survival (log rank, P = 0.80). There is insufficient evidence to show that prophylactic ciprofloxacin can prolong plastic biliary stent patency. The observed trends suggest that ciprofloxacin significantly decreases the incidence of cholangitis and results in improvements in certain aspects of quality of life.",
keywords = "Biliary, Ciprofloxacin, Obstructive jaundice, Quality of life, Stents",
author = "Gabriel Chan and Jeffrey Barkun and Barkun, {Alan N.} and Eric Valois and Albert Cohen and Gad Friedman and Jose Parent and Jonathan Love and Robert Enns and Vicky Baffis and Mansour Jabbari and Peter Szego and Larry Stein and Abraham, {Neena Susan}",
year = "2005",
month = "4",
day = "1",
doi = "10.1016/j.gassur.2004.10.008",
language = "English (US)",
volume = "9",
pages = "481--488",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - The role of ciprofloxacin in prolonging polyethylene biliary stent patency

T2 - A multicenter, double-blinded effectiveness study

AU - Chan, Gabriel

AU - Barkun, Jeffrey

AU - Barkun, Alan N.

AU - Valois, Eric

AU - Cohen, Albert

AU - Friedman, Gad

AU - Parent, Jose

AU - Love, Jonathan

AU - Enns, Robert

AU - Baffis, Vicky

AU - Jabbari, Mansour

AU - Szego, Peter

AU - Stein, Larry

AU - Abraham, Neena Susan

PY - 2005/4/1

Y1 - 2005/4/1

N2 - Plastic stents are the mainstay of the palliation of malignant jaundice but are complicated by recurrent obstruction. Previous trials have failed to demonstrate any improvement in patency with the use of antibiotics. Patients with malignant jaundice were randomized in a double-blind fashion, after polyethylene stent insertion, to receive ciprofloxacin or placebo. After successful stent decompression, there were 50 patients in the treatment arm and 44 in the placebo. There were 14 (33%) episodes of stent occlusion in the ciprofloxacin group versus 23 (49%) in placebo (χ2 test, P = 0.115). There was no significant difference in patency (log-rank test, P = 0.17). There were significantly fewer episodes of cholangitis with ciprofloxacin: 10 (23%) versus 21 (42%) in the placebo (P = 0.047). The ciprofloxacin group also demonstrated a significant improvement in the Social Function domain of the SF-36 Quality of Life Survey at 1 month (paired T test, P = 0.03). The other domains of the SF-36 were not different, nor was survival (log rank, P = 0.80). There is insufficient evidence to show that prophylactic ciprofloxacin can prolong plastic biliary stent patency. The observed trends suggest that ciprofloxacin significantly decreases the incidence of cholangitis and results in improvements in certain aspects of quality of life.

AB - Plastic stents are the mainstay of the palliation of malignant jaundice but are complicated by recurrent obstruction. Previous trials have failed to demonstrate any improvement in patency with the use of antibiotics. Patients with malignant jaundice were randomized in a double-blind fashion, after polyethylene stent insertion, to receive ciprofloxacin or placebo. After successful stent decompression, there were 50 patients in the treatment arm and 44 in the placebo. There were 14 (33%) episodes of stent occlusion in the ciprofloxacin group versus 23 (49%) in placebo (χ2 test, P = 0.115). There was no significant difference in patency (log-rank test, P = 0.17). There were significantly fewer episodes of cholangitis with ciprofloxacin: 10 (23%) versus 21 (42%) in the placebo (P = 0.047). The ciprofloxacin group also demonstrated a significant improvement in the Social Function domain of the SF-36 Quality of Life Survey at 1 month (paired T test, P = 0.03). The other domains of the SF-36 were not different, nor was survival (log rank, P = 0.80). There is insufficient evidence to show that prophylactic ciprofloxacin can prolong plastic biliary stent patency. The observed trends suggest that ciprofloxacin significantly decreases the incidence of cholangitis and results in improvements in certain aspects of quality of life.

KW - Biliary

KW - Ciprofloxacin

KW - Obstructive jaundice

KW - Quality of life

KW - Stents

UR - http://www.scopus.com/inward/record.url?scp=20144389326&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20144389326&partnerID=8YFLogxK

U2 - 10.1016/j.gassur.2004.10.008

DO - 10.1016/j.gassur.2004.10.008

M3 - Article

C2 - 15797227

AN - SCOPUS:20144389326

VL - 9

SP - 481

EP - 488

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 4

ER -