When is antibiotic prophylaxis against pacemaker infective endocarditis (IE) indicated?

Updated: Jan 03, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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No double-blind studies have been performed to support the use of systemically administered antibiotics for the prevention of pacemaker or intracardiac defibrillator infections. However, awaiting definitive studies, the authors recommend prophylactic antibiotics, as with any implantable device. Of course, strict sterile technique must be followed. Antibiotic prophylaxis is not recommended for prevention of CIED infection in patients with pacemakers or intracardiac defibrillators during invasive procedures not directly related to device manipulation. [43] Pacemaker infection due to transient bacteremias is uncommon. [98]

There appeared to be no dramatic increase in rates of hospitalization following the changes to the recommendations for antibiotic prophylaxis in 2007. [27]

For more information, see Antibiotic Prophylactic Regimens for Endocarditis

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