TACE(经导管肝动脉化疗栓塞术),要不要使用抗菌药物?如何使用?
Procedure Embolization and chemoembolization (if intent to create infarction or high likelihood of infarction)
Potential Organisms Encountered S aureus, S epidermidis, Streptococcus spp, Corynebacterium spp, and/or enteric flora (if prior sphincter of Oddi manipulation or bilioenteric surgery)
Routine Prophylaxis Recommended Yes
First-choice Antibiotic No consensus
Common Antibiotic Choices 1.5–3 g ampicillin/sulbactam IV (hepaticchemoembolization); 1 g cefazolin and 500 mg metronidazole IV (hepatic chemoembolization); 2 g ampicillin IV and 1.5 mg/kg gentamicin (hepaticchemoembolization); 1 g ceftriaxone IV (hepaticchemoembolization or renal, splenic embolization); if penicillin-allergic, use vancomycin or clindamycin and aminoglycoside
Comments Special considerations: if patient without intact sphincter of Oddi, consider tazobactam/piperacillin and bowel preparation; procedure classification: clean-contaminated; contaminated (bilioenteric surgery)
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