The Role of Prophylaxis Topical Antibiotics in Cardiac Device Implantation

Khalighi, Koroush; Aung, Thida; Elmi, Farhad

doi:10.1111/pace.12280

Cited by 35 publications

(36 citation statements)

References 14 publications

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“…40 Observational data and meta-analyses support this finding. 4,18,19,41,42 Supporting evidence for using topical antibiotics is lacking; 43 however, recently a promising development has been introduced. The TYRX TM Envelope is an antibacterial envelope releasing minocycline and rifampin in the generator pocket after CIED implantation.…”

Section: Peri-operativementioning

confidence: 99%

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

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Cardiac implantable electronic device (CIED) infection is an increasing problem. Reasons for this are uncertain, but likely relate to an increasing proportion of implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices implanted, as well as implantations in ‘higher risk’ candidates, i.e. patients with heart failure, diabetes and renal failure. Challenges within the field of CIED infections are multiple with prevention being the most important challenge. Careful prescription of CIED treatment and careful patient preparation before implantation is important. Diagnosis is often difficult and delayed by subtle signs of infection. Treatment of CIED infection includes complete system removal in centres experienced in CIED extraction and prolonged antibiotic therapy. Meticulous planning and preparation before system extraction and later CIED re-implantation is essential for better patient outcome. Future strategies for reducing CIED infection should be tested in sufficiently powered, multicentre, randomised controlled trials

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Section: Peri-operativementioning

confidence: 99%

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

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show abstract

“…The complication rates associated with pacemaker or implantable cardioverter‐defibrillator generator REPLACEments and upgrade procedures (REPLACE) registry similarly found no difference in infection rate between those who received postoperative antibiotics and those who did not . In the third study, the role of topical antibiotic was studied in 1008 patients . Enrolled patients received a standard IV preoperative antibiotic prophylaxis and were then randomized into four groups receiving either povidone‐iodine, neomycin ointment, a sterile nonadherent pad, or placebo ointment after procedure.…”

Section: Discussionmentioning

confidence: 99%

Postoperative antibiotic prophylaxis in the prevention of cardiac implantable electronic device infection

Madadi

Kafi

Kheirkhah

et al. 2019

Pacing Clinical Electrophis

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Background The aim of the present study was to determine whether postprocedural antibiotic reduces the risk of infection related to the cardiac implantable electronic device (CIED) implantations. Methods The present investigation is a randomized, prospective, single‐blinded controlled trial. All consecutive patients who presented for new CIED implantation, generator replacement, or upgrade were randomized into the following three groups: (A) no antibiotic, (B) intravenous (IV) antibiotic for 1 day, (C) 1 day IV plus 7 days oral antibiotic. Follow‐up was performed on 10‐12 days; 1, 3, 6 months; and then every 6 months for 2 years. The primary endpoint was any evidence of infection at the generator pocket or systemic infection related to the procedure at short‐term (6‐month) and long‐term (2‐year) follow‐ups. Results Of the 450 patients (72 patients with cardiac resynchronization device) included in the study, the primary endpoint of short‐term infection was reached in one patient (0.2%) in group A and no patients in groups B and C. The endpoint of long‐term infection was reached in nine patients (2%) with equal frequency between three randomized groups (three patients in each group). On multivariable analysis, the only independent predictor of infection was defibrillator implantation (odds ratio, 8.5; 95% confidence interval, 1.6‐45). Conclusions The results of this prospective study showed no benefit for the postoperative antibiotic for the prevention of CIED infection.

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“…24,25 Several observational trials as well as a randomized placebo-controlled trial have shown that the use of various topical antibiotics after the procedure showed no benefit on the rate of CIED infection. 26,27 The REPLACE registry, has demonstrated that at 6-month follow-up, hospitals with high CIED infection rates had sicker patients and lower overall procedural volume. 19 …”

Section: Procedures Relatedmentioning

confidence: 99%

<div>Review of cardiac implantable electronic device related infection</div>

Saliba¹,

Massie²,

Sia³

2016

RRCC

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Cardiac implantable electronic devices (CIEDs) are being used more and more often nowadays. Indications have grown, and access to implantation facilities has increased as well. These devices are often lifesaving, and they can be associated with many other benefits. However, as with any medical procedure, complications can occur. In fact, CIED infection is a prevalent complication that can cause high morbidity and can even lead to death. It is important that most clinicians be familiar with signs and symptoms associated with CIED infection as early diagnosis and treatment lead to better outcomes. Nonetheless, the prevention of such infections remains the cornerstone in the management of CIED-related infections. In this paper, we will review in detail the most significant risk factors that can lead to CIED infection. We will also explore the different available tools that can help decrease the incidence of this complication. In addition, we will summarize the different treatment modalities and the major prevention methods.

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The Role of Prophylaxis Topical Antibiotics in Cardiac Device Implantation

Cited by 35 publications

References 14 publications

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Postoperative antibiotic prophylaxis in the prevention of cardiac implantable electronic device infection

<div>Review of cardiac implantable electronic device related infection</div>

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