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Antibiotikaprofylax vid kirurgiska ingrepp - SBU

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Table 4.9.2 Implantation of permanent pacemaker.<br />

Author<br />

Year<br />

Reference<br />

Country<br />

Study<br />

design<br />

Population<br />

characteristics<br />

Intervention<br />

Method<br />

Number indi<strong>vid</strong>uals<br />

Control<br />

Number<br />

indi<strong>vid</strong>uals<br />

Results<br />

Withdrawal<br />

Drop outs<br />

Study quality<br />

and relevance<br />

Comments<br />

Bluhm<br />

1986<br />

[3]<br />

Sweden<br />

RCT<br />

Consecutive pts scheduled<br />

for pacemaker implantation<br />

with exclusion of pts with<br />

signs of current infection,<br />

being treated with antibiotics<br />

recently and known<br />

intolerance<br />

I: Flucloxacillin 2 g iv over<br />

20 min starting 1 h preoperatively,<br />

+ 1 g po<br />

every 8 h for 5 days<br />

C: Placebo using the<br />

same scheme as for<br />

the active agent<br />

Wound/pacemaker<br />

infection<br />

I: 0<br />

C: 0<br />

Positive culture in<br />

pacemaker pocket<br />

(cultures taken<br />

1 first post-op day<br />

after 3rd dose)<br />

I: Positive cultures<br />

9/31; anaerobic skin<br />

microorganisms 6/9<br />

C: Positive cultures<br />

10/34; anaerobic<br />

skin microorganisms<br />

4/10<br />

Moderate<br />

Placebo-controlled,<br />

double blinded, accurate<br />

follow-up, no power<br />

calculations. Muers<br />

pocket infections 2/234<br />

with antibiotic, 7/197<br />

without. Ramsdale total<br />

wound infection rates<br />

3.3% vs 5.1% – local<br />

antibiotics in both groups<br />

Da Costa<br />

1998<br />

[1]<br />

France<br />

Metaanalysis<br />

Adults pts who underwent<br />

a new permanent pacing<br />

system implantation<br />

or a pulse generator<br />

or lead change.<br />

n=2 023<br />

Follow-up – was varying<br />

no long term ie >2 years<br />

Most pts

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