The Food and Drug Administration describes the Lap-Band system as a specific device approved for use in the treatment of severe obesity for people who have failed with other weight-loss programs. The device consists of a silicone band that goes around the stomach to decrease the effective size of the stomach pouch. The band is connected by a tube to a port which is placed just under the patient's skin. This port provides your doctor an access point to inject or remove saline from the band to tighten or loosen it. Occasionally, the port site may become infected and require treatment with antibiotics or removal of the port.
Oral Antibiotics
Mild infections of the Lap-Band port may be treated with oral antibiotics. Skin infections are most commonly caused by Staphylococcal (staph) or Streptococcal (strep) bacteria. While no hard and fast rules exist, the initial choice of treatment could be with a drug related to penicillin, such as Dicloxacillin and amoxicillin. Cephalexin is a medication in the class called cephalosporins that may also be effective. Additionally, trimethoprim-sulfamethoxazole, a sulfa derivative, may be used. Clindamycin is another alternative, especially in those who are allergic to penicillin-type drugs. A combination drug containing amoxicillin and clavulanate has a broadened spectrum of activity against microorganisms. In certain cases a macrolide antibiotic, such as erythromycin, azithromycin or clarithromycin may be prescribed.
Intravenous Antibiotics
For more serious infections of Lap-Band ports, the port should be removed. Cases like this are usually treated with intravenous (IV) antibiotics. Ampicillin-sulbactam or piperacillin-tazobactam are combination drugs with extended antimicrobial properties. A third generation cephalosporin such as cefotaxime or ceftriaxone would be a reasonable choice. These may be combined with the antibiotic metronidazole to enhance coverage, according to "The Sanford Guide to Antimicrobial Therapy 2009." Doripenem, ertapenem, or imipenem-cilastatin are related medications that may also be prescribed to treat infected Lap-Band ports.
Resistant Organisms
Infection with bacteria that are resistant to the first line antibiotics, or multiple antibiotics, pose a serious threat. One such organism is methicillin-resistant Staphylococcus aureus (MRSA) which requires specific and intensive treatment. Vancomycin or daptomycin given intravenously are recommended by "The Sanford Guide to Antimicrobial Therapy 2009." Linezolid is another alternative.
References
- Food and Drug Administration: The Lap Band Adjustable Gastric Banding System; Summary of Safety and Effectiveness Data
- "The Sanford Guide to Antimicrobial Therapy 2009;" Editors David Gilbert, MD, Robert Moellering MD, George Eliopoulos, MD, Henry Chambers, MD, Michael Saag MD; 2009
