Significant variation in antibiotic regimens for peri-procedural prophylaxis exists among 95% of responding TAVI centers, with cephalosporins used in 70% of cases.
There is significant variability in peri-procedural antibiotic prophylaxis regimens for TAVI across major centers, highlighting the need for randomized trials to establish optimal practices.
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Abstract Background Transcatheter aortic valve implantation (TAVI) is the standard treatment for severe aortic stenosis in patients aged ≥70 years or younger patients at high surgical risk. Although TAVI generally has favorable outcomes, prosthetic valve endocarditis (PVE) remains a serious complication, with high morbidity and mortality. Registry data show post-procedural bacteremia in 4.2% of TAVI patients, mainly caused by Enterococcus spp, streptococci, and Staphylococcus aureus. Antibiotic prophylaxis is recommended, but guidelines are based on limited evidence. Methods A survey of 39 major TAVI centers in Europe and North America assessed peri-procedural antibiotic practices. Thirty-seven centers (95%) responded, providing data on antibiotic type, dosage, and timing. Results Cephalosporins were used in 70% of centers, typically as a single dose; penicillin-based regimens and amoxicillin/clavulanic acid were less common. There was notable variability in antibiotic selection, dosage, and timing. Concerns about cephalosporin efficacy against Enterococci led to interest in alternative regimens. Conclusion Significant variation exists in peri-procedural antibiotic regimens for TAVI. Randomized trials are needed to identify optimal prophylaxis, especially for preventing Enterococcal PVE, and to guide future recommendations.
Søholm et al. (Wed,) reported a other. Significant variation in antibiotic regimens for peri-procedural prophylaxis exists among 95% of responding TAVI centers, with cephalosporins used in 70% of cases.