Antibiotic envelope is associated with reduction in cardiac implantable electronic devices infections especially for high-power device—Systematic review and meta-analysis

Abstract

Background: Infections after cardiac implantable electronic device (CIED) placement are associated with significant morbidity and mortality. The incidence of CIED is increasing overtime despite the optimal use of antimicrobial agents. This systematic review and meta-analysis will address the latest evidence on the use of AE to mitigate the risk of CIED infection, and which subset of patients will they benefit the most. Methods: We performed a comprehensive search on topics that assesses antibiotic envelope and implantable cardiac electronic device up until August 2019. Results: There were a total of 32,329 subjects from six studies. Antibiotic envelope was associated with a lower risk of major infection with OR 0.42 [0.19, 0.97], P =.04; I2: 58% and HR 0.52 [0.32, 0.85], P =.009; I2: 80%. Upon sensitivity analysis by removing a study, the OR became 0.40 [0.27, 0.59], P