P995Short time antibiotic prophylaxis positively affects infection rates after CIED Implantation

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CIEDs infections worldwide are increasing; some studies show reduction of infection rate by prolonged antibiotic prophylaxis. Antimicrobial envelopes approved for infection prophylaxis release two drugs for 7 days, but still is not defined optimal prophylaxis coverage. The aim of study was evaluation of infection rates and usefulness of extended prophylaxis from 2009 to 2017. Definitions: relative infection rate=number of infection/number of procedures/year; absolute infection rate=total number of infection/total number of implants. We divided the observation period in 2 time windows: lower and higher infection rates. Cut off value for higher vs lower was fixed at 0.75%. Perioperative prophylaxis from 2009 to 2013 was ampicillin i.v. followed by ampicillin/sulbactam tid for 3 days. In 2014 we applied guidelines prophylaxis with cefazolin 2 gr i.v. before and 5 hours after operation. Since 2015 we perform preoperative cephazolin 2 gr i.v. followed by cephazolin 2gr i.v. every 8h until 24h. We had 4 infections to 710 procedures: 1 was ICD implant in 2013, 2 were PM implants in 2014 and 1 was PM replacement in 2015. Mean time to infection was 143±38 days. Comparing lowest infection rate period 2009-2013+2016+2017, and highest infection rate period 2014+2015 we observed lower incidence in the former period; Tab 1, fig 1. Because the operative technique was unchanged, we evaluated the relationship between infection rates and prophylaxis duration, finding a discrete grade of correlation (R2=0,2 for relative, and 0,78 for absolute infection rates); fig 2. Conclusions: lowest infection rates are related to duration of prophylaxis in CIEDs procedures in our experience; absolute infection rate as cernter’s performance index demonstrated consistent reduction trend with antibiotical prophylaxis extension. Abstract P995 Figure.

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