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How Long Should Prophylactic Antibiotics be Prescribed for Permanent Pacemaker Implantations? One Day versus Three
Kuang-Hsing Chiang1, Tze-Fan Chao2, Wen-Shin Lee2
1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Division of Cardiology, Department of Internal Medicine; ; Cardiovascular Research Center, Taipei Medical University Hospital; ; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University;
Background:
The implantation of a pacemaker is frequently a life-saving procedure. However, the process of implantation may carry an uncommon but potentially life-threatening infective complication. The prescription of prophylactic antibiotics is an effective way to reduce the risk of infection. The aim of the present study was to investigate the efficacy of 2 prophylactic antibiotic schemes and the possible risk factors associated with device-related infections.
Methods:
A total of 194 consecutive patients who received permanent pacemaker (PPM) implantations were enrolled in this study. Prophylactic antibiotics were prescribed for every patient with a duration of either 1 day or 3 days. The follow-up period was 3 months, and any event of device-related infection was recorded.
Results:
Out of the total 194 patients, there were 5 patients who experienced infective complications after PPM implantation (1 patient in the 1-day group and 4 patients in the 3-day group). The rate of infective complications showed no significant difference between the 2 kinds of antibiotic regimens (1.7% vs. 2.9%, p > 0.99). In the multivariate analysis, only the presence of pocket hematoma was an independent risk factor for infective complications (odds ratio = 3.14, p = 0.018).
Conclusions:
Our study showed that the efficacies for prevention of PPM-related infections were similar between the 1-day and 3-day regimens of prophylactic antibiotics. Pocket hematoma was an independent risk factor of infective complications, and a longer duration of antibiotic treatment may be considered for these patients. Otherwise, a 1-day course of antibiotic prophylaxis may be effective enough to prevent device-related infections, and may further reduce the lengths of hospitalizations.
Key Words:
Complication; Infection; Permanent pacemaker implantation; Prophylatic antibiotics.
Insights
One-day prophylactic antibiotics are as effective as three-day regimens for preventing pacemaker implantation infections. Pocket hematoma is a key risk factor for infection complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Infections
Background:
- Pacemaker implantation is a life-saving procedure but carries a risk of infection.
- Prophylactic antibiotics are used to reduce the incidence of device-related infections.
- Investigating optimal antibiotic prophylaxis duration and risk factors is crucial for patient safety.
Purpose of the Study:
- To compare the efficacy of 1-day versus 3-day prophylactic antibiotic regimens in preventing infections after permanent pacemaker implantation.
- To identify risk factors associated with device-related infections following pacemaker procedures.
Main Methods:
- A study involving 194 patients undergoing permanent pacemaker (PPM) implantation.
- Patients received either a 1-day or 3-day course of prophylactic antibiotics.
- A 3-month follow-up period was conducted to record device-related infections.
Main Results:
- Five patients (2.6%) experienced infective complications: 1 in the 1-day group and 4 in the 3-day group.
- No significant difference in infection rates was observed between the 1-day and 3-day antibiotic regimens (1.7% vs. 2.9%, p > 0.99).
- Pocket hematoma was identified as an independent risk factor for infective complications (OR = 3.14, p = 0.018).
Conclusions:
- Both 1-day and 3-day prophylactic antibiotic regimens demonstrated similar efficacy in preventing PPM-related infections.
- Pocket hematoma is a significant risk factor, warranting consideration for extended antibiotic treatment in affected patients.
- A 1-day antibiotic prophylaxis course may be sufficient, potentially reducing hospitalization duration.
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