13th Annual Global Embolization Symposium & Technologies
Purpose : To evaluate the need for prophylactic post-procedural antibiotics (ABX) following uterine fibroid embolization (UFE) in the prevention of procedure-related infectious complications.
Material and Methods : Patients undergoing UFE at a single center between June 2014 and June 2018 were enrolled in a prospective cohort study and divided into 2 groups. The control group consisted of patients treated before January 2016, who were prescribed post-procedural oral Ciprofloxacin 500mg BID for 7 days. The study group consisted of patients treated after January 2016, who were not prescribed post-procedural ABX. A single dose of pre-procedural ABX was administered to all patients per SIR guidelines. Patient demographics, procedure details and 30-day follow-up data were collected. The primary endpoint was the rate of endomyometritis within 30 days of the procedure.
Results : A total of 293 patients were enrolled in the study, consisting of 144 in the control group and 149 in the study group. Patient demographics and procedure details were similar in both groups. 27 patients in the study group underwent UFE with Embozene particles (Boston Scientific, Marlborough, MA). All other patients underwent UFE utilizing Embosphere particles (Merit Medical Systems, South Jordan, UT). 1/144 (0.7%) and 2/149 (1.3%) of patients presented with infectious complications in the control and experimental groups, respectively. The single infectious complication in the control group was sepsis 9 days postop and was treated with emergent hysterectomy. The 2 complications in the study group consisted of malodorous discharge at 10 and 15 days postop and were each treated with oral ABX. The difference in infection rates between the groups was not statistically significant (p = 1).
Conclusions : Foregoing post-procedural ABX did not result in a significantly increased rate of procedure-related endomyometritis in this cohort. However, the cohort is under-powered to demonstrate non-inferiority of the study group, as the reported post-UFE infection rate is exceedingly low.