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Real-World Use of Prophylactic Antibiotics in Insertable Cardiac Monitor Procedures.
Pacing Clin Electrophysiol 2016; 39(8):837-42PC

Abstract

BACKGROUND

The use of prophylactic antibiotics during insertable cardiac monitor (ICM) procedures is a carryover of the common practice used with therapeutic cardiac implantable electronic devices. We sought to characterize the current practice of ICM insertion procedures to evaluate the influence of prophylactic antibiotic administration on the occurrence of infections.

METHODS

We characterized insertion procedures and procedure-related infections from an ongoing multicenter registry (Reveal LINQ(TM) Registry). In order to accurately capture infections, only patients enrolled before or the day of insertion who also had a record of whether or not preoperative antibiotics were used were included in this analysis. Infections were defined based on the physician's assessment and reported upon occurrence. Patients were categorized into two analysis cohorts based on prophylactic antibiotic use.

RESULTS

We analyzed 375 patients from 14 U.S. centers (age 63.1 ± 15.6 years; male 54.1%). Approximately two-thirds of patients (66.4%) did not receive any preprocedural antibiotics. The overall infection rate was 1.1% (0.3-2.7% confidence interval [CI]) and corresponded to four events. In the group that did not receive preprocedural antibiotics, there were two minor infections (0.8%, [0.1-2.9% CI]), whereas in the group receiving preprocedural antibiotics a serious and a minor infection occurred (1.6%, [0.2-5.6% CI]); this serious infection resulted in an explant.

CONCLUSIONS

Current real-world practice shows that ICM insertions are increasingly performed without the use of prophylactic antibiotics, which is associated with a very low infection rate.

Authors+Show Affiliations

Center for Cardiac and Vascular Research, Washington Adventist Hospital, Rockville, Maryland.Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.Southlake Regional Health Centre, Newmarket, Ontario, Canada.Department of Medicine, University of California, Irvine, California.Department of Neurology Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.Department of Neurology and Stroke Center, University Hospital Essen, Essen, Germany.Medtronic plc, Mounds View, Minnesota.Medtronic plc, Mounds View, Minnesota.Electrophysiology Laboratory, The Valley Hospital Health System, Ridgewood, New Jersey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27198480

Citation

Beinart, Sean C., et al. "Real-World Use of Prophylactic Antibiotics in Insertable Cardiac Monitor Procedures." Pacing and Clinical Electrophysiology : PACE, vol. 39, no. 8, 2016, pp. 837-42.
Beinart SC, Natale A, Verma A, et al. Real-World Use of Prophylactic Antibiotics in Insertable Cardiac Monitor Procedures. Pacing Clin Electrophysiol. 2016;39(8):837-42.
Beinart, S. C., Natale, A., Verma, A., Amin, A., Kasner, S., Diener, H. C., ... Mittal, S. (2016). Real-World Use of Prophylactic Antibiotics in Insertable Cardiac Monitor Procedures. Pacing and Clinical Electrophysiology : PACE, 39(8), pp. 837-42. doi:10.1111/pace.12886.
Beinart SC, et al. Real-World Use of Prophylactic Antibiotics in Insertable Cardiac Monitor Procedures. Pacing Clin Electrophysiol. 2016;39(8):837-42. PubMed PMID: 27198480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Real-World Use of Prophylactic Antibiotics in Insertable Cardiac Monitor Procedures. AU - Beinart,Sean C, AU - Natale,Andrea, AU - Verma,Atul, AU - Amin,Alpesh, AU - Kasner,Scott, AU - Diener,Hans-Christoph, AU - Pouliot,Erika, AU - Franco,Noreli, AU - Mittal,Suneet, Y1 - 2016/06/07/ PY - 2016/03/02/received PY - 2016/05/02/revised PY - 2016/05/09/accepted PY - 2016/5/21/entrez PY - 2016/5/21/pubmed PY - 2017/3/16/medline KW - antibiotics KW - infections KW - insertable cardiac monitor KW - insertion procedure KW - safety SP - 837 EP - 42 JF - Pacing and clinical electrophysiology : PACE JO - Pacing Clin Electrophysiol VL - 39 IS - 8 N2 - BACKGROUND: The use of prophylactic antibiotics during insertable cardiac monitor (ICM) procedures is a carryover of the common practice used with therapeutic cardiac implantable electronic devices. We sought to characterize the current practice of ICM insertion procedures to evaluate the influence of prophylactic antibiotic administration on the occurrence of infections. METHODS: We characterized insertion procedures and procedure-related infections from an ongoing multicenter registry (Reveal LINQ(TM) Registry). In order to accurately capture infections, only patients enrolled before or the day of insertion who also had a record of whether or not preoperative antibiotics were used were included in this analysis. Infections were defined based on the physician's assessment and reported upon occurrence. Patients were categorized into two analysis cohorts based on prophylactic antibiotic use. RESULTS: We analyzed 375 patients from 14 U.S. centers (age 63.1 ± 15.6 years; male 54.1%). Approximately two-thirds of patients (66.4%) did not receive any preprocedural antibiotics. The overall infection rate was 1.1% (0.3-2.7% confidence interval [CI]) and corresponded to four events. In the group that did not receive preprocedural antibiotics, there were two minor infections (0.8%, [0.1-2.9% CI]), whereas in the group receiving preprocedural antibiotics a serious and a minor infection occurred (1.6%, [0.2-5.6% CI]); this serious infection resulted in an explant. CONCLUSIONS: Current real-world practice shows that ICM insertions are increasingly performed without the use of prophylactic antibiotics, which is associated with a very low infection rate. SN - 1540-8159 UR - https://www.unboundmedicine.com/medline/citation/27198480/Real_World_Use_of_Prophylactic_Antibiotics_in_Insertable_Cardiac_Monitor_Procedures_ L2 - https://doi.org/10.1111/pace.12886 DB - PRIME DP - Unbound Medicine ER -