P4479 - Peri-Operative Use of Antibiotics for Per-Oral Esophageal Myotomy: A Real World Retrospective Cohort Study From the TriNetX US Collaborative Networks

Pinghsin Hsieh, MD, Abdellatif Ismail, MD, Raymond Kim, MD
University of Maryland Medical Center, Baltimore, MD

Introduction: Prophylactic antibiotics are frequently prescribed for Per-oral esophageal myotomy (POEM). However, the actual prescribing pattern in the real-world setting has never been studied.

Methods: We conducted a retrospective cohort study using the TrinetX platform, a global research network database based on electronic medical records. Patients who underwent POEM (CPT code 43497) between 1/1/2022 and 05/15/2024 were included for the analysis. The observation period was from the day of POEM to 7 days after POEM. The numbers of patients receiving different antibiotics and the status of their hospitalization were reported on a daily basis throughout the observation period. The most common antibiotics treatment pathways were also reported.

Results: 1870 patients were identified in the database. The demographics included age (57 +/- 19.3 years old), gender (Male/Female: 48%/52%), and race (White/African American: 69.9%/9.9%). 1448 patients (77.4%) had their POEM as an outpatient procedure. Among the 1870 patients, 1575 (84.2%) received antibiotics on the operation day while 295 (15.8%) didn’t. On the procedure day, cefazolin was the most commonly prescribed antibiotics (741/1575, 47%), followed by fluoroquinolone (433/1575, 27.5%) and ampicillin/sulbactam (253/1575, 16.1%). Only 168/1870 (9%) and 51/1870 (2.7%) patients were still prescribed intravenous (IV) antibiotics on the 2nd day and 3rd day after POEM. 24 (1.3%) patients continued to be prescribed IV antibiotics on the 7th day after POEM. The mean hospitalization days were 2.11 days. Table 1 showed the numbers of patients receiving different antibiotics and the status of their hospitalization from 3 days prior to POEM to 7 days after POEM.

Discussion: While prophylactic antibiotics prescription is a common practice in the United States, a significant portion of patients didn’t receive antibiotics on the procedure day. The most commonly prescribed antibiotics are cefazolin, fluoroquinolones, and ampicillin-sulbactam. Less than 3% of patient stayed on IV antibiotics between 3-7 days after POEM.




Disclosures:


Pinghsin Hsieh, MD, Abdellatif Ismail, MD, Raymond Kim, MD. P4479 - Peri-Operative Use of Antibiotics for Per-Oral Esophageal Myotomy: A Real World Retrospective Cohort Study From the TriNetX US Collaborative Networks, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.