Role of antibiotic envelopes in preventing cardiac implantable electronic device infection: A meta-analysis of 14 859 procedures

Ashish Kumar; Rajkumar Doshi; Mariam Shariff

doi:10.1002/joa3.12262

Role of antibiotic envelopes in preventing cardiac implantable electronic device infection: A meta-analysis of 14 859 procedures

J Arrhythm. 2019 Nov 18;36(1):176-179. doi: 10.1002/joa3.12262. eCollection 2020 Feb.

Authors

Ashish Kumar¹, Rajkumar Doshi², Mariam Shariff¹

Affiliations

¹ Department of Critical Care Medicine St John's Medical College Hospital Bangalore India.
² Department of Internal Medicine University of Nevada Reno School of Medicine Reno NV USA.

Abstract

Introduction: We conducted an updated meta-analysis assessing the role of antibiotic envelopes in preventing Cardiac implantable electronic devices (CIED)-related infections as compared to standard infection prevention strategies.

Methods: A systematic search was conducted on Medline/PubMed and EMBASE/Ovid database. We used Mantel-Haenszel method with fixed-effect model to compute risk ratio (RR) with 95% confidence interval (CI). We also performed subgroup and trial sequential analysis on the data.

Results: Antibiotic envelope reduced the risk of both all infections [RR: 0.41, CI: 0.31-0.54, P < .05, I ² = 75%, χ ² P < .05] and major infections [RR: 0.48, CI: 0.32-0.70, P < .05, I ² = 60%, χ ² P = .04].

Conclusion: Prophylactic use of antibiotic envelopes as an adjuvant therapy to standard infection prevention strategies, helps in reducing the risk of CIED infections.

Keywords: antibiotic envelope; cardiac implantable electronic devices.