title: Orally administered levofloxacin as prophylaxis against pacemaker infection.
abstract: OBJECTIVE
  Despite paying careful attention to surgical details and sterile procedures, infection often occurs after pacemaker implantation. The prophylactic use of intravenously or orally administered antibiotics should therefore be considered. The present study aimed to evaluate the efficacy of orally administered levofloxacin (LVFX) as prophylaxis against pacemaker infection.
  
  
  METHODS
  Thirty-nine patients who underwent permanent pacemaker implantation or pacemaker generator replacement due to battery depletion were included in the present study. Patients were divided into two groups (groups 1 and 2) and administered different antibiotics accordingly. Group 1 included 19 patients (75.7+/-9.3 years of age; 10 men and nine women) who were intravenously administered 2 g of cefazolin daily for five days postoperatively. Group 2 included 20 patients (73.7+/-14.4 years of age; 10 men and 10 women) who were orally administered 200 mg of LVFX 2 h before surgery and then 400 mg daily for five days thereafter.
  
  
  RESULTS
  In group 1, the mean white blood cell concentrations before, and one, four and seven days after surgery were 4979+/-1330/mm(3), 6453+/-1200/mm(3), 5463+/-1303/mm(3) and 5632+/-1154/mm(3), respectively, and in group 2, they were 5931+/-1316/mm(3), 7062+/-1774/mm(3), 5708+/-1402/mm(3) and 5345+/-1506/mm(3), respectively. In group 1, the mean blood C-reactive protein concentrations before, and one, four and seven days after surgery were 0.27+/-0.34 mg/dL, 0.48+/-0.48 mg/dL, 1.04+/-0.99 mg/dL and 0.52+/-0.48 mg/dL, respectively, and in group 2, they were 0.43+/-0.54 mg/dL, 0.52+/-0.27 mg/dL, 0.61+/-0.42 mg/dL and 0.56+/-0.63 mg/dL, respectively. The inflammatory parameters showed similar responses in both groups.
  
  
  CONCLUSIONS
  Orally administered LVFX following permanent pacemaker implantation can prevent pacemaker infection as successfully as intravenously administered cefazolin.
authors.affiliation: Department of Cardiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Morito
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamanouchi
authors.forename: Sunao
authors.initials: S
authors.lastname: Kodama
authors.forename: Takeaki
authors.initials: T
authors.lastname: Ohta
authors.forename: Eiji
authors.initials: E
authors.lastname: Yahiro
authors.forename: Kei
authors.initials: K
authors.lastname: Miyoshi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Urata