Why the study?
How do European centres diagnose, treat, and prevent CIED infections?
How do European centres diagnose, treat, and prevent CIED infections?
A survey of European centres demonstrates good adherence to lead extraction guidelines for systemic CIED infections, although variations remain in prophylactic antibiotic practices.
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Survey data support lead extraction for systemic CIED infections; observational findings leave prophylaxis optimization open for prospective trials.
The purpose of our survey is to analyse the clinical approach used to prevent and treat cardiovascular implantable electronic device (CIED) infections in Europe. The survey involves high-volume implanting centres. According to the survey the incidence of CIED infections shows a slight decrease in most centres and is substantially under 2% in the majority of centres interviewed. However, there are still differences in terms of prophylactic antibiotic therapy: 8.9% of the centres administer oxacillin as preoperative treatment, 4.4% of them do not give any antibiotic therapy, all centres use some kind of skin antisepsis, but only 42.2% use chlorhexidine. In case of local infection, 43.5% of centres perform lead extraction as first approach. In the case of systemic infection or evidence of lead or valvular endocarditis, 95% of centres treat these conditions by extracting the leads, which indicates that the adherence to the lead extraction guidelines is quite good.
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Bongiorni et al. (2012) studied this question.
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