ArticleBMC infectious diseases2026
Assessment of antibiotic prophylaxis post cardiac implantable electronic device implantation: a retrospective cohort study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCardiac implantable electronic devices (CIEDs) manage arrhythmias and prevent sudden cardiac death, but related infections are rising. Pre-implantation antibiotics lower infection rates, while postoperative use is debated. PURPOSE: To evaluate current postoperative prophylactic antibiotic practices and CIED infection rates.
methodA retrospective cohort study at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, included adults > 18 who underwent CIED implantation from 2017 to 2022. The primary outcome measured infection rates post-antibiotic prophylaxis. Data were analyzed using Stata 18.5.
resultsThe study included 200 patients, predominantly male (62%), with a median age of 64 years. Common comorbidities included hypertension (71.5%), diabetes (65.5%), and heart failure (64%). All patients received pre-operative antibiotics, primarily cefazolin (88.4%) and vancomycin (6.5%). Most patients (95%) received postoperative antibiotics, most commonly amoxicillin/clavulanic acid (83.6%), while 14% received combination therapy. Among patients who received postoperative antibiotics (n = 190), 1 definite infection (0.5%) and 3 possible infections (1.5%) were observed, with no infections identified among those who did not receive postoperative antibiotics (n = 10). Regarding duration, possible infections occurred in 1.0% of patients receiving antibiotics for more than 7 days and 2.3% of those receiving 7 days or less. In the regimen analysis, definite infection occurred in 0.6% of patients receiving single-agent therapy and none in those receiving combination therapy. Given the low number of events, these findings are descriptive and should be interpreted as exploratory.
conclusionProphylactic antibiotics for 7 days or less, or a single agent, was not associated with a detectable difference in infection rates. A larger prospective study including patients not receiving prophylactic antibiotics post-implantation is needed to distinguish infection rates between those who did and did not receive them. CLINICAL TRIAL NUMBER: Not applicable.
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