Antibiotic prophylaxis with a single dose of cefazolin during pacemaker implantation: incidence of long-term infective complications.
OBJECTIVE
Systemic and localized infections related to permanent pacemaker implantation are not common, but are serious and potentially life-threatening complications. The aims of this prospective observational study were: (1) to assess the safety and long-term efficacy of a simplified scheme of antibiotic prophylaxis, and (2) to identify the predictors of long-term infective complications, in patients undergoing pacemaker implantation or replacement.


RESULTS
From October 1998 to July 2001, 852 patients (mean age 77.0 +/- 9.2 years; 474 men) who underwent new permanent pacemaker implantation (69.6%) or pulse generator replacement (30.4%) received a mini-bag of 2 g of cefazolin diluted in 50 mL of saline solution, administered intravenously in 20 minutes before the beginning of the procedure. Early (within 2 months of implantation) and late major and minor infective complications were recorded. During the earlier phase, minor complications were observed in 9 patients (1%). During the long-term phase of the surveillance (mean 25.6 +/- 11.0 months, range 12-55 months) major infective complications were observed in 6 patients (0.7%). On multivariate analysis, no clinical or procedural variable predicted the occurrence of long-term infective complications.


CONCLUSIONS
Our data indicate the safety and efficacy of a single, intravenous 2 g dose of cefazolin in preventing infective complications related to pacemaker implantation or replacement. No clinical or procedural variable predicted the occurrence of long-term infective complications.
Bertaglia
Emanuele
E
Dipartimento di Cardiologia, Ospedale Civile, Mirano (Venice), Italy. cardiologia.mirano@ulss13mirano.ven.it
Zerbo
Francesca
F
Zardo
Susanna
S
Barzan
Daniela
D
Zoppo
Franco
F
Pascotto
Pietro
P
D000368:Aged; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
D002437:Cefazolin