Bacteremia and Procalcitonin Levels in Peroral Endoscopic Myotomy for Achalasia
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Purpose
Peroral Endoscopic Myotomy (POEM) is a novel, promising endoscopic technique for achalasia because it is safer and more effective than traditional Heller's myotomy. However, the issue of antibiotic prophylaxis in POEM has evoked considerable controversy recently. Therefore, we conduct this study to elucidate the status of POEM-related bacteremia and procalcitonin levels in order to preliminary observe whether antibiotic prophylaxis is needed.
| Condition | Intervention |
|---|---|
|
Esophageal Achalasia |
Drug: no antibiotic prophylaxis Drug: second-generation cephalosporin |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Prevention |
| Official Title: | Bacteremia and Procalcitonin Levels in Peroral Endoscopic Myotomy for Achalasia |
- Blood culture positive incidence [ Time Frame: after 12 hours of POEM ] [ Designated as safety issue: Yes ]To compare the positive incidence of blood cultures between antibiotic prophylaxis and no antibiotic prophylaxis.
- procalcitonin level [ Time Frame: after 12 hours of POEM ] [ Designated as safety issue: Yes ]
To observe the changes of procalcitonin levels after POEM in which no antibiotic is administered.
To compare the procalcitonin levels between antibiotic prophylaxis and no antibiotic prophylaxis.
- clinical manifestation [ Time Frame: during hospital stay and up to 1 week ] [ Designated as safety issue: Yes ]To observe the changes of temperature, heart rate, respiratory rate, white blood cell counts, neutrophile granulocyte counts in perioperative period.
| Estimated Enrollment: | 60 |
| Study Start Date: | October 2012 |
| Estimated Study Completion Date: | August 2013 |
| Estimated Primary Completion Date: | April 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: no antibiotic prophylaxis
These patients are in no antibiotic prophylaxis group will not be administered antibiotic prophylactically.
|
Drug: no antibiotic prophylaxis
These patients are in no antibiotic prophylaxis group will not be administered antibiotic prophylactically.
|
|
Active Comparator: second-generation cephalosporin
These patients are in antibiotic prophylaxis group will be administered second-generation cephalosporin prophylactically.
|
Drug: second-generation cephalosporin
These patients are in antibiotic prophylaxis group will be administered second-generation cephalosporin prophylactically.
|
Detailed Description:
Objective: To elucidate the status of POEM-related bacteremia and procalcitonin levels in order to preliminary observe whether antibiotic prophylaxis is needed.
Interventions: Patients with achalasia diagnosed by symptoms, endoscopy and barium swallow eligible for POEM are randomized to either use antibiotic prophylactically or not.
Main outcome measurements: Blood culture positive incidence; secondary outcomes are procalcitonin levels, C-reactive protein levels, white blood cell counts and so on.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Clinical diagnosis of esophageal achalasia
- Ready to have the treatment as POEM and no contraindication of POEM
- Ability to get informed consent
Exclusion Criteria:
- Patients who had indications for antibiotic prophylaxis as determined by the American Society for Gastrointestinal Endoscopy
- Patients who had received antibiotics for any reason within the previous 7days
- Patients who had possible signs of any infection at the time of the procedure
- Patients who had chronic inflammatory diseases need hormonotherapy : such as rheumatic arthritis or inflammatory bowel diseases.
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More Information
No publications provided
| Responsible Party: | Shanghai Zhongshan Hospital |
| ClinicalTrials.gov Identifier: | NCT01750385 History of Changes |
| Other Study ID Numbers: | B2012-089 |
| Study First Received: | November 20, 2012 |
| Last Updated: | December 12, 2012 |
| Health Authority: | China: Food and Drug Administration |
Keywords provided by Shanghai Zhongshan Hospital:
|
Esophageal Achalasia antibiotic prophylaxis blood culture procalcitonin levels |
Additional relevant MeSH terms:
|
Esophageal Achalasia Bacteremia Esophageal Diseases Bacterial Infections Sepsis Infection Systemic Inflammatory Response Syndrome Inflammation Pathologic Processes |
Esophageal Motility Disorders Deglutition Disorders Gastrointestinal Diseases Digestive System Diseases Anti-Bacterial Agents Cephalosporins Anti-Infective Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013