766 Prevention of Arrhythmia Device Infection Trial (PADIT): Pilot Study Results

Krahn, Andrew D.; Philippon, François; Exner, D.; Birnie, David H.; Saginur, Raphael; Mangat, Iqwal; Thibault, Bernard; Khaykin, Y.; Healey, Jeffrey S.; Parkash, Ratika; Gula, L.J.; Tang, Airong; Essebag, Vidal; Simpson, Chris; Rinne, Claus; Connolly, S.

doi:10.1016/j.cjca.2012.07.691

Cited by 36 publications

(102 citation statements)

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“…Then, why should we apply tailored antibiotic prophylaxis after the device implantation? Our study and the results of the newly published multicenter Prevention of Arrhythmia Device Infection Trial (PADIT) showed that more than a single preoperative dose of antibiotic does not help to prevent device infections.…”

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confidence: 70%

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There is no tailored approach for antibiotic prophylaxis after the device implantation

Haghjoo

2019

Pacing Clinical Electrophis

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confidence: 70%

“…Similarly, 40% of the PADIT population was categorized as high‐risk for infection. Interestingly, subgroup analysis in PADIT trial could not identify any patient‐ or procedure‐related factors with benefit from postoperative antibiotic prophylaxis …”

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confidence: 99%

There is no tailored approach for antibiotic prophylaxis after the device implantation

Haghjoo

2019

Pacing Clinical Electrophis

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“…The estimated rate of CIED infection ranges from 0.2% to 5% depending on several factors, such as type of device and patient's comorbidities . Two recent studies have dramatically changed our understanding of risk of infection and prevention measures.…”

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confidence: 99%

“…Two recent studies have dramatically changed our understanding of risk of infection and prevention measures. In the Prevention of Arrhythmia Device Infection Trial (PADIT), the risk of hospital admission for infection in 19,559 patients was 0.90%, with a risk of just 1.11% in high‐risk patients . In the subsequent Worldwide Randomized Antibiotic Envelope Infection Prevention Trial (WRAP‐IT), the risk of major infection in 6983 high‐risk patients was 1.2% .…”

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confidence: 99%

“…Two recent landmark randomized trials on antibiotic prophylaxis will influence our practice. The PADIT Trial was a cluster crossover trial of 19 603 patients in 28 centers that compared standard preoperative cefazolin with a protocol that included cefazolin and vancomycin preoperatively, bacitracin pocket wash, and 2 days of oral cephalosporin postoperatively. This was a multicenter prospective, randomized, un‐blinded trial with blinded adjudication, with a primary endpoint of hospitalization for device infection within 12 months of the index procedure.…”

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confidence: 99%

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Antibiotic prophylaxis for cardiac implantable electronic devices: Is the jury out yet?

Shenasa

Krahn²

2019

Pacing Clinical Electrophis

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Device infections related to cardiac resynchronization therapy in clinical practice–An analysis of its prevalence, risk factors and routine surveillance at a single center university hospital

Ostrowska

Gkiouzepas

Kurland

et al. 2021

Clinical Cardiology

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Background The implantation rates of cardiac implantable electronic devices have steadily increased, accompanied by a steeper rise of device related infections (DRI). Hypothesis The prevalence of DRI for cardiac resynchronization therapy (CRT) is higher in clinical practice than reported previously, even at a university hospital, and likely higher than reported to the national device registry. Methods Electronic medical records of consecutive patients undergoing a CRT procedure between January 2016 and December 2017 were analyzed. Clinical history, procedure related variables and complications were reviewed by specialists in cardiology and infectious diseases. Results A total of 171 patients, mean aged 74 years, 138 males (80.7%) were included. Twelve DRI occurred in 10 patients during mean 2.5 years follow‐up, giving a prevalence of 7% (incidence of 29/1000 person‐years). Reoperation, pocket haematoma, ≥3 procedures, previous device infection and indwelling central venous line were the strongest predictive factors according to univariate analysis. Out of 63/171 (36.8%) major complications, 31(49.2%) were lead‐related. There were 49/171 (28.7%) reoperations and 15/171 (8.8%) minor complications. The number major complications and DRI reported to the national device registry were 7/171 (4.1%) and 2/171 (0.6%), respectively, reflecting a 5‐fold underreporting. Conclusions The high rate of CRT device infections is in sharp contrast to those reported by others and to the national device registry. Although a center specific explanation cannot be excluded, the high rates highlight a major issue with registries, reinforcing the need for better surveillance and automatic reporting of device related complications.

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766 Prevention of Arrhythmia Device Infection Trial (PADIT): Pilot Study Results

Cited by 36 publications

References 0 publications

There is no tailored approach for antibiotic prophylaxis after the device implantation

There is no tailored approach for antibiotic prophylaxis after the device implantation

Antibiotic prophylaxis for cardiac implantable electronic devices: Is the jury out yet?

Device infections related to cardiac resynchronization therapy in clinical practice–An analysis of its prevalence, risk factors and routine surveillance at a single center university hospital

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