Perioperative Antibiotics Did Not Prevent Postendoscopic Submucosal Dissection Coagulation Syndrome in Study

Postendoscopic coagulation syndrome (PECS) is common after endoscopic submucosal dissection (ESD), and prior data have indicated that perioperative antibiotics reduced the syndrome. 

In this Japanese multicenter study, PECS was defined as localized abdominal tenderness and fever ≥37.6 °C, white blood cell (WBC) counts >10,000, or elevated C-reactive protein levels without evidence of perforation. The antibiotic group received 3 g of ampicillin-sulbactam just before ESD, 8 hours after ESD, and the morning after ESD. Patients with a penicillin allergy were excluded from the study, as were 22 patients with perforation.

PECS occurred in 4.7% of patients treated with antibiotics and 7.5% of nonrecipients of antibiotics; P=.29. WBC counts the day after ESD were 7400 with antibiotics and 8100 without (P<.001). There were no differences between the groups in the time to discharge or complications.