The Clinical Analysis On The Prophylactic Use Of Antibiotics During Perioperative Period In Cardiac Permanent Pacemaker Implanting

Objective: This is a retrospective clinical analysis for the infections related features of using antibiotic in preoperative period of permanent cardiac pacemaker for 722 patients, which aimed to help better understanding how to choose a reasonable and standardized prophylactic antimicrobial application for the patients with permanent cardiac pacemaker during the preoperative period.Methods: Seven hundreds and twenty-two patients with single, dual and three chamber cardiac pacemaker from Cardiology Department of Lanzhou University Second Hospital and Cardiology Department of General Hospital of Lanzhou Military Command between January 2010 and December 2013. According to the different antibiotic use program, the patients were divided into four groups, including group A(n=187cases), group B(n=183), group C(n=174) and group D(n=178), respectively. In group A, B and C, the patients used prophylactic intravenous antibiotics 30min-1 hour before the surgery and used antimicrobial agents (1 time/12hour) after the surgery. Patients of group A used antimicrobial agents for more than three days (average 6.52 ±1.13 days), and group B for three days, and Group C did not used. But Group D didn’t use any antibiotics before and after the surgery. We changed the four groups of patients in the first, third and fifth day after the surgery, observed surgical incision and pacemaker pocket at the time of hospitalization, and followed up at the first and third month respectively after the surgery. Finally apply SPSS22.0 statistical software was applied to analyze the data.Results:(1) Basic data comparison between the four groups: four groups of patients with gender, age, basic information, such as body temperature, blood routine preoperative general data comparison, had no differences (P> 0.05), comparable. (2) The observations:A group of 4 cases of postoperative fever rate was 2.14%, 3 cases of group B was 1.63%, 5 cases of group C was 2.87%, 2 cases of group D was 1.12%, compared four groups, had no differences (P>0.05). (3) Postoperative incision inflammation and pocket 7 cases of group A was 3.74%, the incidence of hemorrhage 4 cases of group B was 2.19%,5 cases (2.87%), group C group D 3 cases (1.69%), four groups of comparative differences have no statistical significance (P> 0.05).Pocket hemorrhage patients via local sandbags oppression and cut after removal of hemorrhage, incisions healed well. (4) The incidence of postoperative infection, 2 cases of group A was 1.07%,1 case of group B was 0.55%, no special discomfort of private prosecution has not been group C and group D postoperative infection occurs, four groups of patients in group D, for control group two comparison, thad no differences (P> 0.05).Conclusion: At present, both at home and abroad about cardiac permanent pacemaker implanted perioperative prophylactic use of antibiotics and time period has not been clear guidelines recommend. Both at home and abroad, the use of antibiotics were mostly empirical medication. Combination and other research results of this study, we propose a pacemaker preoperative prophylactic intravenous drip 1-2 hours antibiotic treatment, postoperative incision should be based on patients and general condition. Pacemaker devices infection more likely related to replace the electrodes, secondary and rebuild many times, the results of pacemaker implantation perioperative prophylactic use of antibiotics to provide more valuable clinical basis.