Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey
Purpose Survey the usage and application protocol of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device (CIED) infection prophylaxis. Background Local antibiotic usage for CIED infection prophylaxis, in particular pocket irrigation, is a well‐known strategy but wi...
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| Veröffentlicht in: | Pacing and clinical electrophysiology 2018-10, Vol.41 (10), p.1298-1306 |
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| container_title | Pacing and clinical electrophysiology |
| container_volume | 41 |
| creator | Zheng, Qi Di Biase, Luigi Ferrick, Kevin J. Gross, Jay N. Guttenplan, Nils A. Kim, Soo G. Krumerman, Andrew K. Palma, Eugen C. Fisher, John D. |
| description | Purpose
Survey the usage and application protocol of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device (CIED) infection prophylaxis.
Background
Local antibiotic usage for CIED infection prophylaxis, in particular pocket irrigation, is a well‐known strategy but with little data on its clinical effectiveness.
Methods
An anonymous voluntary online survey was sent to a total of 2,092 arrhythmia‐oriented cardiologists in 51 countries (1,490 from the United States).
Results
There were 487 responses (response rate 23.3%: U.S. 28.2%, outside of the U.S. 11.1%). Eighty‐seven percent of respondents use intraoperative antimicrobial agent pocket irrigation and/or an antimicrobial eluting pouch to reduce CIED infection. Fifty‐four percent of respondents believe that it is effective to use an antimicrobial agent pocket irrigation to reduce CIED infection; 33% of respondents are uncertain; a few consider this strategy ineffective (13%) or offered no opinion. Significant differences exist in the practice patterns and beliefs between the U.S. and non‐U.S. countries (P |
| doi_str_mv | 10.1111/pace.13473 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2088756863</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2114543489</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3573-9dc59fc5b81f98a82e4cf83ac8d8f2d8f2f7b5e030e504290c2305f67c225d033</originalsourceid><addsrcrecordid>eNp9kcFKHTEUhoNU9NZ20weQQDcijE0myUziTi7aFoQW0fWQyZzYaGYyJjO3vY_i2zbjtV100cAhEL7z_yfnR-gDJWc0n0-jNnBGGa_ZHlpRwUkhqVBv0IpQXheSSXWI3qb0QAipCBcH6JARSlSl5Ao93yXAwWI9TK53JobWaY_1PQwTHoN5hAm7GN29nlwYsA0RGx07FzY6mdnriF0_-tysWw8YPJgphsEZ3MHGGcBusPlpaR1jGH9svf7l0jm-gTT7KWEbQ5-tMzZBHF48snua4wa279C-1T7B-9f7CN1dXd6uvxTX3z5_XV9cF4aJmhWqM0JZI1pJrZJalsCNlUwb2UlbLmXrVgBhBAThpSKmZETYqjZlKTrC2BE62enmCZ9mSFPTu2TA519BmFNTEilrUclqQT_-gz6EOc_tM0UpF5xxqTJ1uqPyNlOKYJsxul7HbUNJswTWLIE1L4Fl-PhVcm576P6ifxLKAN0BP52H7X-kmu8X68ud6G-N36Qo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2114543489</pqid></control><display><type>article</type><title>Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Zheng, Qi ; Di Biase, Luigi ; Ferrick, Kevin J. ; Gross, Jay N. ; Guttenplan, Nils A. ; Kim, Soo G. ; Krumerman, Andrew K. ; Palma, Eugen C. ; Fisher, John D.</creator><creatorcontrib>Zheng, Qi ; Di Biase, Luigi ; Ferrick, Kevin J. ; Gross, Jay N. ; Guttenplan, Nils A. ; Kim, Soo G. ; Krumerman, Andrew K. ; Palma, Eugen C. ; Fisher, John D.</creatorcontrib><description>Purpose
Survey the usage and application protocol of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device (CIED) infection prophylaxis.
Background
Local antibiotic usage for CIED infection prophylaxis, in particular pocket irrigation, is a well‐known strategy but with little data on its clinical effectiveness.
Methods
An anonymous voluntary online survey was sent to a total of 2,092 arrhythmia‐oriented cardiologists in 51 countries (1,490 from the United States).
Results
There were 487 responses (response rate 23.3%: U.S. 28.2%, outside of the U.S. 11.1%). Eighty‐seven percent of respondents use intraoperative antimicrobial agent pocket irrigation and/or an antimicrobial eluting pouch to reduce CIED infection. Fifty‐four percent of respondents believe that it is effective to use an antimicrobial agent pocket irrigation to reduce CIED infection; 33% of respondents are uncertain; a few consider this strategy ineffective (13%) or offered no opinion. Significant differences exist in the practice patterns and beliefs between the U.S. and non‐U.S. countries (P < 0.05). Ninety‐eight percent of respondents report using the same pocket irrigation protocol for permanent pacemaker versus implantable cardioverter defibrillator. Bacitracin (48%), vancomycin (39%), and a cephalosporin (29%) are the most commonly chosen antibiotics. A majority of the respondents are unaware of the cost of using antimicrobial agent pocket irrigation (69%) and neither are they concerned (67%).
Conclusion
This international survey suggests that, while there are little clinical data to support or discourage such practice, the usage of antimicrobial agent pocket irrigation for CIED infection prophylaxis is widely used in current practice.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.13473</identifier><identifier>PMID: 30109698</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Anti-Infective Agents - administration & dosage ; Antibiotic Prophylaxis - methods ; Antibiotics ; Antimicrobial agents ; Arrhythmia ; Bacitracin ; cardiovascular implantable electronic device ; Data processing ; Defibrillators ; Defibrillators, Implantable ; Female ; Humans ; infection ; Infections ; Irrigation ; Male ; Middle Aged ; Pacemaker, Artificial ; pocket irrigation ; Practice Patterns, Physicians' - statistics & numerical data ; Prophylaxis ; Prosthesis-Related Infections - prevention & control ; Surveys and Questionnaires ; Therapeutic Irrigation - methods ; Vancomycin</subject><ispartof>Pacing and clinical electrophysiology, 2018-10, Vol.41 (10), p.1298-1306</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3573-9dc59fc5b81f98a82e4cf83ac8d8f2d8f2f7b5e030e504290c2305f67c225d033</citedby><cites>FETCH-LOGICAL-c3573-9dc59fc5b81f98a82e4cf83ac8d8f2d8f2f7b5e030e504290c2305f67c225d033</cites><orcidid>0000-0001-6508-4047 ; 0000-0003-2748-8715</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpace.13473$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpace.13473$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30109698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zheng, Qi</creatorcontrib><creatorcontrib>Di Biase, Luigi</creatorcontrib><creatorcontrib>Ferrick, Kevin J.</creatorcontrib><creatorcontrib>Gross, Jay N.</creatorcontrib><creatorcontrib>Guttenplan, Nils A.</creatorcontrib><creatorcontrib>Kim, Soo G.</creatorcontrib><creatorcontrib>Krumerman, Andrew K.</creatorcontrib><creatorcontrib>Palma, Eugen C.</creatorcontrib><creatorcontrib>Fisher, John D.</creatorcontrib><title>Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>Purpose
Survey the usage and application protocol of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device (CIED) infection prophylaxis.
Background
Local antibiotic usage for CIED infection prophylaxis, in particular pocket irrigation, is a well‐known strategy but with little data on its clinical effectiveness.
Methods
An anonymous voluntary online survey was sent to a total of 2,092 arrhythmia‐oriented cardiologists in 51 countries (1,490 from the United States).
Results
There were 487 responses (response rate 23.3%: U.S. 28.2%, outside of the U.S. 11.1%). Eighty‐seven percent of respondents use intraoperative antimicrobial agent pocket irrigation and/or an antimicrobial eluting pouch to reduce CIED infection. Fifty‐four percent of respondents believe that it is effective to use an antimicrobial agent pocket irrigation to reduce CIED infection; 33% of respondents are uncertain; a few consider this strategy ineffective (13%) or offered no opinion. Significant differences exist in the practice patterns and beliefs between the U.S. and non‐U.S. countries (P < 0.05). Ninety‐eight percent of respondents report using the same pocket irrigation protocol for permanent pacemaker versus implantable cardioverter defibrillator. Bacitracin (48%), vancomycin (39%), and a cephalosporin (29%) are the most commonly chosen antibiotics. A majority of the respondents are unaware of the cost of using antimicrobial agent pocket irrigation (69%) and neither are they concerned (67%).
Conclusion
This international survey suggests that, while there are little clinical data to support or discourage such practice, the usage of antimicrobial agent pocket irrigation for CIED infection prophylaxis is widely used in current practice.</description><subject>Adult</subject><subject>Aged</subject><subject>Anti-Infective Agents - administration & dosage</subject><subject>Antibiotic Prophylaxis - methods</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Arrhythmia</subject><subject>Bacitracin</subject><subject>cardiovascular implantable electronic device</subject><subject>Data processing</subject><subject>Defibrillators</subject><subject>Defibrillators, Implantable</subject><subject>Female</subject><subject>Humans</subject><subject>infection</subject><subject>Infections</subject><subject>Irrigation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pacemaker, Artificial</subject><subject>pocket irrigation</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Prophylaxis</subject><subject>Prosthesis-Related Infections - prevention & control</subject><subject>Surveys and Questionnaires</subject><subject>Therapeutic Irrigation - methods</subject><subject>Vancomycin</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFKHTEUhoNU9NZ20weQQDcijE0myUziTi7aFoQW0fWQyZzYaGYyJjO3vY_i2zbjtV100cAhEL7z_yfnR-gDJWc0n0-jNnBGGa_ZHlpRwUkhqVBv0IpQXheSSXWI3qb0QAipCBcH6JARSlSl5Ao93yXAwWI9TK53JobWaY_1PQwTHoN5hAm7GN29nlwYsA0RGx07FzY6mdnriF0_-tysWw8YPJgphsEZ3MHGGcBusPlpaR1jGH9svf7l0jm-gTT7KWEbQ5-tMzZBHF48snua4wa279C-1T7B-9f7CN1dXd6uvxTX3z5_XV9cF4aJmhWqM0JZI1pJrZJalsCNlUwb2UlbLmXrVgBhBAThpSKmZETYqjZlKTrC2BE62enmCZ9mSFPTu2TA519BmFNTEilrUclqQT_-gz6EOc_tM0UpF5xxqTJ1uqPyNlOKYJsxul7HbUNJswTWLIE1L4Fl-PhVcm576P6ifxLKAN0BP52H7X-kmu8X68ud6G-N36Qo</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Zheng, Qi</creator><creator>Di Biase, Luigi</creator><creator>Ferrick, Kevin J.</creator><creator>Gross, Jay N.</creator><creator>Guttenplan, Nils A.</creator><creator>Kim, Soo G.</creator><creator>Krumerman, Andrew K.</creator><creator>Palma, Eugen C.</creator><creator>Fisher, John D.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6508-4047</orcidid><orcidid>https://orcid.org/0000-0003-2748-8715</orcidid></search><sort><creationdate>201810</creationdate><title>Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey</title><author>Zheng, Qi ; Di Biase, Luigi ; Ferrick, Kevin J. ; Gross, Jay N. ; Guttenplan, Nils A. ; Kim, Soo G. ; Krumerman, Andrew K. ; Palma, Eugen C. ; Fisher, John D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3573-9dc59fc5b81f98a82e4cf83ac8d8f2d8f2f7b5e030e504290c2305f67c225d033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anti-Infective Agents - administration & dosage</topic><topic>Antibiotic Prophylaxis - methods</topic><topic>Antibiotics</topic><topic>Antimicrobial agents</topic><topic>Arrhythmia</topic><topic>Bacitracin</topic><topic>cardiovascular implantable electronic device</topic><topic>Data processing</topic><topic>Defibrillators</topic><topic>Defibrillators, Implantable</topic><topic>Female</topic><topic>Humans</topic><topic>infection</topic><topic>Infections</topic><topic>Irrigation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pacemaker, Artificial</topic><topic>pocket irrigation</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Prophylaxis</topic><topic>Prosthesis-Related Infections - prevention & control</topic><topic>Surveys and Questionnaires</topic><topic>Therapeutic Irrigation - methods</topic><topic>Vancomycin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zheng, Qi</creatorcontrib><creatorcontrib>Di Biase, Luigi</creatorcontrib><creatorcontrib>Ferrick, Kevin J.</creatorcontrib><creatorcontrib>Gross, Jay N.</creatorcontrib><creatorcontrib>Guttenplan, Nils A.</creatorcontrib><creatorcontrib>Kim, Soo G.</creatorcontrib><creatorcontrib>Krumerman, Andrew K.</creatorcontrib><creatorcontrib>Palma, Eugen C.</creatorcontrib><creatorcontrib>Fisher, John D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zheng, Qi</au><au>Di Biase, Luigi</au><au>Ferrick, Kevin J.</au><au>Gross, Jay N.</au><au>Guttenplan, Nils A.</au><au>Kim, Soo G.</au><au>Krumerman, Andrew K.</au><au>Palma, Eugen C.</au><au>Fisher, John D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>2018-10</date><risdate>2018</risdate><volume>41</volume><issue>10</issue><spage>1298</spage><epage>1306</epage><pages>1298-1306</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>Purpose
Survey the usage and application protocol of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device (CIED) infection prophylaxis.
Background
Local antibiotic usage for CIED infection prophylaxis, in particular pocket irrigation, is a well‐known strategy but with little data on its clinical effectiveness.
Methods
An anonymous voluntary online survey was sent to a total of 2,092 arrhythmia‐oriented cardiologists in 51 countries (1,490 from the United States).
Results
There were 487 responses (response rate 23.3%: U.S. 28.2%, outside of the U.S. 11.1%). Eighty‐seven percent of respondents use intraoperative antimicrobial agent pocket irrigation and/or an antimicrobial eluting pouch to reduce CIED infection. Fifty‐four percent of respondents believe that it is effective to use an antimicrobial agent pocket irrigation to reduce CIED infection; 33% of respondents are uncertain; a few consider this strategy ineffective (13%) or offered no opinion. Significant differences exist in the practice patterns and beliefs between the U.S. and non‐U.S. countries (P < 0.05). Ninety‐eight percent of respondents report using the same pocket irrigation protocol for permanent pacemaker versus implantable cardioverter defibrillator. Bacitracin (48%), vancomycin (39%), and a cephalosporin (29%) are the most commonly chosen antibiotics. A majority of the respondents are unaware of the cost of using antimicrobial agent pocket irrigation (69%) and neither are they concerned (67%).
Conclusion
This international survey suggests that, while there are little clinical data to support or discourage such practice, the usage of antimicrobial agent pocket irrigation for CIED infection prophylaxis is widely used in current practice.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30109698</pmid><doi>10.1111/pace.13473</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6508-4047</orcidid><orcidid>https://orcid.org/0000-0003-2748-8715</orcidid></addata></record> |
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| ispartof | Pacing and clinical electrophysiology, 2018-10, Vol.41 (10), p.1298-1306 |
| issn | 0147-8389 1540-8159 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2088756863 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Anti-Infective Agents - administration & dosage Antibiotic Prophylaxis - methods Antibiotics Antimicrobial agents Arrhythmia Bacitracin cardiovascular implantable electronic device Data processing Defibrillators Defibrillators, Implantable Female Humans infection Infections Irrigation Male Middle Aged Pacemaker, Artificial pocket irrigation Practice Patterns, Physicians' - statistics & numerical data Prophylaxis Prosthesis-Related Infections - prevention & control Surveys and Questionnaires Therapeutic Irrigation - methods Vancomycin |
| title | Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey |
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