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Background <p>Cardiac implantable electronic devices (CIEDs) manage arrhythmias and prevent sudden cardiac death, but related infections are rising. Pre-implantation antibiotics lower infection rates, while postoperative use is debated.</p> Purpose <p>To evaluate current postoperative prophylactic antibiotic practices and CIED infection rates.</p> Method <p>A retrospective cohort study at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, included adults &gt; 18 who underwent CIED implantation from 2017 to 2022. The primary outcome measured infection rates post-antibiotic prophylaxis. Data were analyzed using Stata 18.5.</p> Results <p>The study included 200 patients, predominantly male (62%), with a median age of 64 years. Common comorbidities included hypertension (71.5%), diabetes (65.5%), and heart failure (64%). All patients received pre-operative antibiotics, primarily cefazolin (88.4%) and vancomycin (6.5%). Most patients (95%) received postoperative antibiotics, most commonly amoxicillin/clavulanic acid (83.6%), while 14% received combination therapy. Among patients who received postoperative antibiotics (<i>n</i> = 190), 1 definite infection (0.5%) and 3 possible infections (1.5%) were observed, with no infections identified among those who did not receive postoperative antibiotics (<i>n</i> = 10). Regarding duration, possible infections occurred in 1.0% of patients receiving antibiotics for more than 7 days and 2.3% of those receiving 7 days or less. In the regimen analysis, definite infection occurred in 0.6% of patients receiving single-agent therapy and none in those receiving combination therapy. Given the low number of events, these findings are descriptive and should be interpreted as exploratory.</p> Conclusion <p>Prophylactic antibiotics for 7 days or less, or a single agent, was not associated with a detectable difference in infection rates. A larger prospective study including patients not receiving prophylactic antibiotics post-implantation is needed to distinguish infection rates between those who did and did not receive them.</p> Clinical trial number <p>Not applicable.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月8日

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  • Sarah Aljohani,
  • Lama Alfehaid,
  • Meshary Almeshary,
  • Hind Almodaimegh,
  • Majed Almutairi,
  • Sultan Al Raddadi

摘要

Background

Cardiac implantable electronic devices (CIEDs) manage arrhythmias and prevent sudden cardiac death, but related infections are rising. Pre-implantation antibiotics lower infection rates, while postoperative use is debated.

Purpose

To evaluate current postoperative prophylactic antibiotic practices and CIED infection rates.

Method

A retrospective cohort study at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, included adults > 18 who underwent CIED implantation from 2017 to 2022. The primary outcome measured infection rates post-antibiotic prophylaxis. Data were analyzed using Stata 18.5.

Results

The study included 200 patients, predominantly male (62%), with a median age of 64 years. Common comorbidities included hypertension (71.5%), diabetes (65.5%), and heart failure (64%). All patients received pre-operative antibiotics, primarily cefazolin (88.4%) and vancomycin (6.5%). Most patients (95%) received postoperative antibiotics, most commonly amoxicillin/clavulanic acid (83.6%), while 14% received combination therapy. Among patients who received postoperative antibiotics (n = 190), 1 definite infection (0.5%) and 3 possible infections (1.5%) were observed, with no infections identified among those who did not receive postoperative antibiotics (n = 10). Regarding duration, possible infections occurred in 1.0% of patients receiving antibiotics for more than 7 days and 2.3% of those receiving 7 days or less. In the regimen analysis, definite infection occurred in 0.6% of patients receiving single-agent therapy and none in those receiving combination therapy. Given the low number of events, these findings are descriptive and should be interpreted as exploratory.

Conclusion

Prophylactic antibiotics for 7 days or less, or a single agent, was not associated with a detectable difference in infection rates. A larger prospective study including patients not receiving prophylactic antibiotics post-implantation is needed to distinguish infection rates between those who did and did not receive them.

Clinical trial number

Not applicable.