Presentation Outline ICHP Annual Meeting September 13-15

Antibiotic Prophylaxis
American Heart Association (AHA)
• Preoperative prophylaxis with an antibiotic that has
in vitro activity against staphylococci should be
administered (Level of Evidence: A)
• Antimicrobial prophylaxis in the postoperative period
is not recommended due to lack of evidence and risk
of adverse drug events and antimicrobial resistance
Baddour L, et al. Circulation. 2010;121:458‐477.
Study Purpose
• To determine if postoperative antibiotic prophylaxis
with cephalexin administered for 72 hours reduces
the incidence of infection in patients undergoing
CIED procedure
Research Hypothesis
• There is no difference in the incidence of CIED infection
between 72 hour postoperative cephalexin and no
postoperative antibiotic regimens
Methods‐ Outcomes
Endpoint
Primary Compare the incidence of CIED related infections
between 72 hour postoperative cephalexin to no
postoperative antibiotics
Secondary •Identify the patient characteristics that correlated with
the primary outcome
•Time to infection
Background
• At Rush University Medical Center (RUMC), 72 hours
of postoperative prophylactic antibiotics are used
after CIED implantation
• Currently no study has specifically examined the
efficacy of postoperative antibiotic prophylaxis in
this patient population
Methods ‐ Design
• Retrospective chart review
– January 2007 – October 2011
• Single center, Rush University Medical Center
– 673 bed, university affiliated medical center
Methods‐ Patient Population
Inclusion criteria Exclusion criteria
• Age ≥ 18 and < 89 years • Documented penicillin and/or
cephalosporin allergy
• Recipients of a new, upgrade,
generator replacement revision
or lead revision of CIED
• Received antibiotics for another
iindication di ti prior i to t CIED
•Received preoperative
antibiotics with cefazolin prior to
CIED procedure
• Pregnancy
• Patients who underwent
thoracotomy with implantation
8/29/2012
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