Antimicrobial prophylaxis in dogs undergoing catheter-based cardiac interventions and pacemaker implantation - A...

Guidelines for prophylactic antimicrobial use for catheter-based cardiac interventions and pacemaker implementation in dogs do not exist. Optimizing antimicrobial use by rationalizing indications and the duration of administration is essential against the ever-growing threat of antimicrobial resistance. The aim of our study was to reveal the current habits of prophylactic antimicrobial use among veterinarians who perform transvascular cardiac interventions in dogs. A digital survey was offered via the mailing list of an international veterinary cardiology-interest group. The 141 respondents reported large variations in protocols (e.g., 47 different prophylaxis protocols for pacemaker implantation). Protocols differed on administration (yes/no), drug, and the route and duration of administration (only intravenous, or intravenous followed by oral antimicrobials). The median duration of antimicrobial course was 7 days (range: 0-21 days). Antimicrobial prophylaxis was administered by 89 % of 141 respondents for occlusion of patent ductus arteriosus, 76 % of 139 respondents for balloon valvuloplasty of pulmonary valve stenosis, 93 % of 56 respondents for transpulmonary stenting, and 96 % of 136 respondents for transvenous pacemaker implantation. The existence of institutional guidelines was reported by 30 % of the respondents, although these also showed substantial variation (e.g., 27 guidelines from 40 institutions for pacemaker implantation). Veterinarians use prophylactic antimicrobials more often and for longer periods for cardiac interventions than their human counterparts. Antibiotic prophylaxis shows little consistency between veterinarians, and does not appear to be supported by evidence of necessity. This warrants re-evaluation of use, and creation of guidelines describing rational use of antimicrobials in interventional cardiac procedures.