{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:06:56Z","timestamp":1788631616255,"version":"build-2803163510"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:00:00Z","timestamp":1637280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"[H30-Kansei-Shitei-003]"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background and aim<\/jats:title><jats:p>Prophylactic administration of antibiotics within 24 hours of surgery is recommended to reduce the risk of infection. We conducted a prospective study to compare the efficacy of single administration of antibiotics with a historical control of continuous administration of antibiotics for radiofrequency ablation (RFA) of malignant liver tumors.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Between February 1, 1999 and November 30, 2010, a total of 6,763 RFA treatments were performed in 2,355 patients, using a protocol with continuous administration of prophylactic antibiotics. On December 1, 2010, we began using a revised protocol with a single administration of prophylactic antibiotics, while continuing to use the old continuous administration protocol for patients who declined the new protocol. Interim analysis was performed to assess the safety of the single administration protocol. Thereafter, from April 1, 2012, all patients were treated using the new protocol. Risk factors for infectious complications of RFA were assessed using logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>From December 2010 to March 2012, 766 RFA treatments were performed in 663 patients using the new antibiotic protocol. Infectious complications were observed following 4 of these treatments (0.52%). As the upper limit of the confidence interval (CI) resulting from a one-sided binomial test was exactly the prespecified limit of 1.0%, from April 2012 onwards, we treated all patients using the new protocol with single administration of prophylactic antibiotics. A total of 3,547 RFA treatments were performed using the single administration protocol. Univariable logistic regression indicated that prior transcatheter arterial chemoembolization (TACE) and maximal tumor diameter were significant risk factors for infectious complications (P = 0.04 and P &lt; 0.001, respectively). Multivariable analysis indicated that the adjusted hazard ratio of single vs. continuous administration of antibiotics was 1.20 (95% CI: 0.53\u20132.75; P = 0.66).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>The rate of infectious complications related to RFA was acceptably low. Single administration of prophylactic antibiotics did not significantly increase the rate of infectious complications related to RFA, compared with a more intensive antibiotic protocol.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0259641","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T18:24:35Z","timestamp":1637346275000},"page":"e0259641","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics"],"prefix":"10.1371","volume":"16","author":[{"given":"Ryo","family":"Nakagomi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3021-2517","authenticated-orcid":true,"given":"Ryosuke","family":"Tateishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Mikami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taijiro","family":"Wake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki Nishibatake","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuma","family":"Nakatsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Minami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Uchino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Enooku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinari","family":"Asaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichiro","family":"Shiina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Koike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"pone.0259641.ref001","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1148\/radiology.197.1.7568806","article-title":"Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection","volume":"197","author":"T Livraghi","year":"1995","journal-title":"Radiology"},{"key":"pone.0259641.ref002","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.2214\/ajr.160.5.7682378","article-title":"Percutaneous ethanol injection therapy for hepatocellular carcinoma: results in 146 patients","volume":"160","author":"S Shiina","year":"1993","journal-title":"AJR Am J Roentgenol"},{"key":"pone.0259641.ref003","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1002\/(SICI)1097-0142(19990415)85:8<1694::AID-CNCR8>3.0.CO;2-3","article-title":"Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma: comparison with percutaneous ethanol injection therapy","volume":"85","author":"T Seki","year":"1999","journal-title":"Cancer"},{"key":"pone.0259641.ref004","doi-asserted-by":"crossref","first-page":"S159","DOI":"10.1053\/j.gastro.2004.09.030","article-title":"Treatment of hepatocellular carcinoma by percutaneous tumor ablation methods: Ethanol injection therapy and radiofrequency ablation","volume":"127","author":"M Omata","year":"2004","journal-title":"Gastroenterology"},{"key":"pone.0259641.ref005","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1097\/00000658-200009000-00010","article-title":"Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis","volume":"232","author":"SA Curley","year":"2000","journal-title":"Ann Surg"},{"key":"pone.0259641.ref006","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1148\/radiol.2343040350","article-title":"Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation","volume":"234","author":"R Lencioni","year":"2005","journal-title":"Radiology"},{"key":"pone.0259641.ref007","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1002\/cncr.20892","article-title":"Percutaneous radiofrequency ablation for hepatocellular carcinoma. 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