Cardiovascular implantable electronic devices (CIED) improve quality of life of patients with cardiac arrhythmias and also improves chances of survival. CIEDs, however it may cause complications. To avoid these complications surgical prophylaxis in CIED insertion is required to avoid infection. Due to the rise in antimicrobial resistance the use of antimicrobial agents should be rational and under control. To prevent resistance of antibiotics their use and duration of therapy should be monitored. The high-end and restricted antibiotics should be used only if organisms grow in cultures or if suggested by infectious disease specialists. This review focuses on empirical antibiotics used as prophylaxis. The purpose of this document is to outline the antimicrobial options which can be used as an empirical prophylactic agent in CIED infections.