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1. padit Trial
Prevention of Arrhythmia
Device Infection Trial
Cluster randomized crossover trial
Objective: To assess the efficacy of additional antibiotic
measures compared with a single dose of preoperative
antibiotics among patients undergoing implantation of a
cardiac implantable electronic device (CIED).
19,603
2018
Patients who required cardiac implantable
electronic device were randomized to:-
VS
primary outcome
secondary outcome
Hospitalization due to device
infection within 1 year %
Incremental
antibiotics
(n = 9,976)
Conventional
treatment
(n = 9,627)
OR: 0.77; 95% CI: 0.56 to 1.05; P=0.10
Need for
surgical intervention %
P=0.57
Hospitalizations in high
risk patients %
OR: 0.82; 95% CI: 0.59 to 1.15; P=0.26
0.8 1.0
1.0 1.1
1.0 1.2
Conclusion: The results of this trial indicate that a strategy of
additional antibiotics among patients undergoing CIED implanta-
tion is not superior a single dose of preoperative antibiotics in
reducing device infections. Overall infection rates were low, even
among patients deemed to be high-risk (~1%).
Krahn AD, et al. JACC. 2018 Dec 18;72(24):3098-3109.
Note: Incremental antibiotics treatment: pre-procedural cefazolin plus vancomycin,
intraprocedural bacitracin pocket wash, and 2-day post-procedural oral cephalexin.
Conventional treatment: pre-procedural cefazolin infusion