title: Surgical infection prophylaxis for left ventricular assist device implantation.
abstract: BACKGROUND
  Antimicrobial prophylaxis is commonly administered to patients undergoing left ventricular assist device (LVAD) surgeries to prevent infectious complications. However, optimal surgical infection prophylaxis (SIP) for LVAD surgeries is not well defined.
  
  
  METHODS
  We conducted an electronic survey to characterize LVAD SIP used at different centers performing LVAD implantation.
  
  
  RESULTS
  Responses were received from 23 of 85 centers (27%). Of 21 centers that provided usable data about their LVAD SIP regimens for nonpenicillin allergic patients, 42.9% reported using a four-drug regimen (three antibiotics plus fluconazole), 23.8% reported using a three-drug regimen (three antibiotics or two antibiotics plus fluconazole), 23.8% reported using a regimen of two antibiotics, and 9.5% reported using vancomycin alone. A similar pattern was observed among SIP regimens for penicillin-allergic patients. Criteria for discontinuation of SIP and use of decolonization strategies also varied widely across centers.
  
  
  CONCLUSIONS
  Our results demonstrate wide variability in LVAD SIP regimens and underscore the lack of consensus regarding best practice.
authors.affiliation: Department of Pharmacy Services, University of Michigan Health System and College of Pharmacy, Ann Arbor, Michigan 48109–0008, USA. pcwalker@umich.edu
authors.forename: Paul C
authors.initials: PC
authors.lastname: Walker
authors.forename: Daryl D
authors.initials: DD
authors.lastname: DePestel
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Miles
authors.forename: Preeti N
authors.initials: PN
authors.lastname: Malani
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D004359:Drug Therapy, Combination; D019538:Health Care Surveys; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D019919:Prosthesis Implantation / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000890:Anti-Infective Agents