INTRODUCTION: The rates of cardiac implantable electronic device (CIED) infections have risen over the past decade and are associated with increased hospitalizations and mortality. A number of preventative strategies have been developed including an antibiotic coated envelope, but it has yet to gain widespread use. METHODS: A meta-analysis was performed on controlled studies of the antibiotic envelope. PubMed and Google Scholar were searched for studies comparing infection rates with and without the use of an antibiotic envelope. Studies including both new implants and pulse generator replacements were included in the analysis. RESULTS: Five studies were included in the meta-analysis. A total of 4,490 patients underwent CIED implantation, 1,798 with an antibiotic envelope and 2,692 without an envelope. In the pooled cohort, the envelope was associated with a 69% relative risk reduction in CIED infection (0.31 [0.17, 0.58] 95% CI, P = 0.0002). Propensity matched data from three studies were analyzed to ensure accurate comparison. In the risk-matched cohort, infections were significantly lower in the envelope group (3 vs. 26, P < 0.0003). CONCLUSION: The use of antibiotic envelopes in CIED implant is associated with a significantly lower rate of infection.
INTRODUCTION: The rates of cardiac implantable electronic device (CIED) infections have risen over the past decade and are associated with increased hospitalizations and mortality. A number of preventative strategies have been developed including an antibiotic coated envelope, but it has yet to gain widespread use. METHODS: A meta-analysis was performed on controlled studies of the antibiotic envelope. PubMed and Google Scholar were searched for studies comparing infection rates with and without the use of an antibiotic envelope. Studies including both new implants and pulse generator replacements were included in the analysis. RESULTS: Five studies were included in the meta-analysis. A total of 4,490 patients underwent CIED implantation, 1,798 with an antibiotic envelope and 2,692 without an envelope. In the pooled cohort, the envelope was associated with a 69% relative risk reduction in CIED infection (0.31 [0.17, 0.58] 95% CI, P = 0.0002). Propensity matched data from three studies were analyzed to ensure accurate comparison. In the risk-matched cohort, infections were significantly lower in the envelope group (3 vs. 26, P < 0.0003). CONCLUSION: The use of antibiotic envelopes in CIED implant is associated with a significantly lower rate of infection.
Authors: Jinghao Nicholas Ngiam; Tze Sian Liong; Meng Ying Sim; Nicholas W S Chew; Ching-Hui Sia; Siew Pang Chan; Toon Wei Lim; Tiong-Cheng Yeo; Paul Anantharajah Tambyah; Poay Huan Loh; Kian Keong Poh; William K F Kong Journal: J Clin Med Date: 2022-05-29 Impact factor: 4.964
Authors: Yves Longtin; Philippe Gervais; David H Birnie; Jia Wang; Marco Alings; François Philippon; Ratika Parkash; Jaimie Manlucu; Paul Angaran; Claus Rinne; Benoit Coutu; R Aaron Low; Vidal Essebag; Carlos Morillo; Damian Redfearn; Satish Toal; Giuliano Becker; Michel Degrâce; Bernard Thibault; Eugene Crystal; Stanley Tung; John LeMaitre; Omar Sultan; Matthew Bennett; Jamil Bashir; Felix Ayala-Paredes; Leon Rioux; Martin E W Hemels; Leon H R Bouwels; Derek V Exner; Paul Dorian; Stuart J Connolly; Andrew D Krahn Journal: Open Forum Infect Dis Date: 2021-10-14 Impact factor: 3.835
Authors: M Rizwan Sohail; Zerelda Esquer Garrigos; Claude S Elayi; Kun Xiang; John N Catanzaro Journal: Pacing Clin Electrophysiol Date: 2020-03-05 Impact factor: 1.976