作者
Andrew D Krahn, Yves Longtin, François Philippon, David H Birnie, Jaimie Manlucu, Paul Angaran, Claus Rinne, Benoit Coutu, R Aaron Low, Vidal Essebag, Carlos Morillo, Damian Redfearn, Satish Toal, Giuliano Becker, Michel Degrâce, Bernard Thibault, Eugene Crystal, Stanley Tung, John LeMaitre, Omar Sultan, Matthew Bennett, Jamil Bashir, Felix Ayala-Paredes, Philippe Gervais, Leon Rioux, Martin EW Hemels, Leon HR Bouwels, Bob van Vlies, Jia Wang, Derek V Exner, Paul Dorian, Ratika Parkash, Marco Alings, Stuart J Connolly
发表日期
2018/12/10
期刊
Journal of the American College of Cardiology
卷号
72
期号
24
页码范围
3098-3109
出版商
Journal of the American College of Cardiology
简介
Background
Infection of implanted medical devices has catastrophic consequences. For cardiac rhythm devices, pre-procedural cefazolin is standard prophylaxis but does not protect against methicillin-resistant gram-positive organisms, which are common pathogens in device infections.
Objective
This study tested the clinical effectiveness of incremental perioperative antibiotics to reduce device infection.
Methods
The authors performed a cluster randomized crossover trial with 4 randomly assigned 6-month periods, during which centers used either conventional or incremental periprocedural antibiotics for all cardiac implantable electronic device procedures as standard procedure. Conventional treatment was pre-procedural cefazolin infusion. Incremental treatment was pre-procedural cefazolin plus vancomycin, intraprocedural bacitracin pocket wash, and 2-day post-procedural oral cephalexin. The primary outcome …
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AD Krahn, Y Longtin, F Philippon, DH Birnie, J Manlucu… - Journal of the American College of Cardiology, 2018