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Published on: February 28, 2012

Assessment of antibiotic prophylaxis post cardiac implantable electronic device implantation: a retrospective cohort

Sarah Aljohani1, Lama Alfehaid2,3,4, Meshary Almeshary3,4

  • 1Pharmaceutical Care Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.

BMC Infectious Diseases
|May 8, 2026
PubMed

Insights

Postoperative prophylactic antibiotics for cardiac implantable electronic devices (CIEDs) showed no significant difference in infection rates. Further research is needed to confirm these findings for CIED infections.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Cardiac implantable electronic devices (CIEDs) are crucial for managing arrhythmias and preventing sudden cardiac death.
  • CIED-related infections are an increasing concern.
  • The role of postoperative prophylactic antibiotics in preventing CIED infections remains debated.

Purpose of the Study:

  • To assess current practices of postoperative prophylactic antibiotic use in CIED recipients.
  • To determine the incidence of CIED infections in relation to postoperative antibiotic administration.

Main Methods:

  • A retrospective cohort study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia.
  • The study included 200 adult patients who underwent CIED implantation between 2017 and 2022.
  • Infection rates post-antibiotic prophylaxis were the primary outcome, analyzed using Stata 18.5.

Main Results:

  • The cohort (n=200) had a median age of 64 years, with common comorbidities including hypertension and diabetes.
  • All patients received pre-operative antibiotics; 95% received postoperative antibiotics.
  • A low rate of infection was observed (0.5% definite, 1.5% possible), with no infections in the small group (n=10) not receiving postoperative antibiotics. Exploratory analysis showed no difference in infection rates based on duration or single-agent vs. combination therapy.

Conclusions:

  • Current prophylactic antibiotic strategies (≤7 days or single agent) did not show a detectable difference in CIED infection rates.
  • Larger prospective studies, including a control group not receiving prophylactic antibiotics, are necessary to definitively compare infection rates.
Abstract

Keywords:
AntibioticsArrhythmiasCardiac implantable electronic devicesPacemakerPocket infectionPostoperative

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