From January 2011 to July 2013, 112 pacemakers were implanted at the ICL, Hospital Queen Elizabeth II. The longer duration of the pacemaker implantation or the hardware change procedure took was associated with an increased risk of pacemaker infection. The choices of antibiotic before and after the procedure will also play role in protecting the patient from infection. In addition, we found that the use of cefazolin after implantation procedure may reduce the risk of getting infected compared to the other antibiotics. Contrarily, age, preoperative antibiotic choices and gender were not associated with a risk of pacemaker infection.
The incidence of pacemaker infection in our institution has increased from 4.92% in 2012 to 17.86% in second quarter of 2013. This number is comparable to the data retrieved from National Inpatient Sample reported that there was a 224% increase in the pacemaker infection rate from 1193 to 2008 while the Implantable Cardioverter Defibrillator (ICD) remained constant.5 According to Patel J, incident of infection increases among patients with diabetes, heart failure, renal failure and respiratory failure. However, our study found that patients’ presenting illness prior to pacemaker implantation
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al studied the use of cefazolin as prophylaxis antibiotic almost similar with the practice in our institution.10 11 They confirmed that cefazolin has the safety and efficacy in preventing infective complications related to pacemaker implantation or replacement.10 12 Thus, it is comparable to our study that practice of using cefazolin after the implantation procedure will have the benefit in reducing the risk of infection after implantation