Evidence map›Paper›PMID 39695877›Full record

ArticleAntimicrobial resistance and infection control2024

Rates of post procedural prophylactic antibiotic use following cardiac implantable electronic device insertion and the impact on surgical site infections in Alberta, Canada.

Elissa Rennert-May, Jenine Leal, Zuying Zhang, Irina Rajakumar, Stephanie Smith, John M Conly, Derek Exner, Vikas Kuriachan, Derek Chew

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Antimicrobial resistance and infection control, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Postoperative antibiotic prophylaxis following cardiac implantable electronic device implantation and the risk of device infection.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elissa Rennert-MayDepartment of Medicine, University of Calgary, Calgary, AB, Canada. elissa.rennertmay@ucalgary.ca.
Jenine LealDepartment of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Zuying ZhangDepartment of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Irina RajakumarDepartment of Pharmacy, Alberta Health Services, Calgary, AB, Canada.
Stephanie SmithDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
John M ConlyDepartment of Medicine, University of Calgary, Calgary, AB, Canada.
Derek ExnerLibin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada.
Vikas KuriachanLibin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada.
Derek ChewDepartment of Community Health Sciences, University of Calgary, Calgary, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe necessity of post procedural prophylactic antibiotics following clean surgeries is controversial. While most evidence suggests that there is no benefit from these additional antibiotics and guidelines do not support their use, there is a paucity of evidence as to how often they are still being used and their impact on infection outcomes. The current study assessed the use of prophylactic antibiotics following cardiac implantable electronic device (CIED) implantations in the province of Alberta, and their impact on infection and mortality.

methodsWe conducted a population-based cohort study in the province of Alberta. Administrative data was used to link all patients ≥ 18 who underwent outpatient CIED implantation from January 1, 2011 through December 31, 2019 to antibiotics commonly used for surgical prophylaxis which were prescribed within 48 h of implantation. The primary outcome, explored with an adjusted Poisson model, was incidence of complex surgical site infection within one year of device implantation. All-cause mortality was a secondary outcome.

resultsPost implantation prophylactic antibiotics were used 41% of the time overall, though the rate has been decreasing over time. The most commonly used prophylactic antibiotic was cefalexin (52%). When adjusted analyses were completed, there was no difference in the outcome of infection between those who did and did not receive post implantation prophylactic antibiotics (Relative Risk 0.74, 95% CI 0.46-1.17) and there was no difference in mortality (Relative Risk 0.8, 95% CI 0.63-1.02).

conclusionsThe use of prophylactic antibiotics following CIED implantation does not correlate to a reduced rate of complex surgical site infection or reduced mortality. The widespread use of these antibiotics, which is not guideline concordant, suggests the need for targeted antimicrobial stewardship interventions for surgical prophylaxis to ensure that antibiotic use is being optimized. Further work should explore other adverse outcomes associated with this antibiotic usage and stewardship programs should explore interventions to educate and reduce antibiotic use for this indication.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisDefibrillators, ImplantableSurgical Wound InfectionAgedAged, 80 and overAlbertaCohort StudiesFemaleHumansIncidenceMaleMiddle AgedPacemaker, ArtificialRetrospective StudiesAnti-Bacterial AgentsAntibiotic ProphylaxisAntimicrobial stewardshipCIED infectionsSurgical Site infections

Identifiers

PMID39695877
PMCPMC11656946

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.