Antibiotic prophylaxis for permanent pacemaker implantation: A survey in chinese electrophysiological centers

Background: The practice of antibiotic prophylaxis for permanent pacemaker implantation varied widely in the real world of clinical practice due to no guidelines. The present study aims to investigate the use of antibiotic prophylaxis peri- and postimplantation of pacemaker in China. Materials and Methods: A total of 141 adult heart centers performing device implantation were asked using an E-mail or paper questionnaire to collect data regarding the use of antibiotics before or at implantation and duration of postimplantation. Subsequent telephone calls and E-mails were used to ascertain dubious data if necessary. Results: The final analysis included 135 centers (95.7% of total contacted) covering 7 main geographic regions of China. One hundred and twenty-six of the 135 centers (93.3%) used prophylactic antibiotics peri- and postimplantation. Among these centers, 107 centers (84.9%) selected first- or second-generation cephalosporins. In 100 centers (79.4%) of those used systemic antibiotics, an initial dose was given 0.5–2 h before surgery. With respect to duration of antibiotics administration, 99 centers of those used prophylactic antibiotics (78.6%) continued antibiotic therapy for 24–72 h while only 10 centers (7.9%) just administrated a single dose of antimicrobial agent before commencement of a procedure. Forty-eight of the 135 centers (35.6%) used intrapocket antibiotics at implantation, and gentamicin was the most commonly used antimicrobial agent (in 39/48 centers). Conclusion: Although the administration of prophylactic antibiotics before permanent pacemaker implantation has been implemented widely and routinely, our results showed that some electrophysiological centers still used no systemic antibiotic prophylaxis before or at the implantation. A significant difference exists in the timing, duration, and type of antibiotics use. Clinical trial evidence are required to guide optimal antibiotic prophylaxis for device implantation.