open access

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Original article
Published online: 2021-08-09
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The safety, efficacy and cost-effectiveness of gentamycin-collagen sponge in multi-component prevention strategy of cardiac implantable electronic device infections — the single-center experience

Krzysztof Kaczmarek, Aleksander Strzelecki, Paweł Ptaszyński, Jerzy K Wranicz, Iwona Cygankiewicz
DOI: 10.33963/KP.a2021.0089
·
Pubmed: 34392518

open access

Online first
Original article
Published online: 2021-08-09

Abstract

Background: Cardiac implantable electronic device (CIED) infections are associated with significant morbidity, mortality and increased health care expenses. Apart from standard systemic antibiotic therapy locally acting agents are under investigation as potential approach for prevention of this complication.
Aims: The aim of our study was to summarize our experience with gentamycin-collagen sponge (GCS) in multi-component prevention strategy of cardiac implantable electronic device infection.
Methods: We retrospectively analyzed medical records of 312 consecutive patients who underwent CIED-related surgery and had at least 6 months follow-up. All the individuals had GCS applied during surgery. An incidence of CIEDs-related infection in our group was compared to risk level calculated according to commonly used scores. An analysis of cost-effectiveness was also performed.
Results: Incidence of CIED-related infection, defined as primary endpoint, occurred relatively rarely (0.33%) as compared to the infection risk calculated according to commonly used scores (PADIT — 0.83%; CIED-AI — 0.90% or Mittal score — 1.00%; P <0.001 — for all). We did not record any complication related to GCS. We analyzed cost-effectiveness of our GCS-based approach, which appeared to be financially beneficial (number needed to treat 149–200; difference of CIED infection treatment cost and GCSs price was 5093–26525 $).
Conclusions: We conclude that: 1) use of GCS to reduce CIEDs infections is feasible and safe; 2) our multi-component prevention strategy involving the GCS application seems to significantly reduce rate of CIED infection and it is cost-effective.

Abstract

Background: Cardiac implantable electronic device (CIED) infections are associated with significant morbidity, mortality and increased health care expenses. Apart from standard systemic antibiotic therapy locally acting agents are under investigation as potential approach for prevention of this complication.
Aims: The aim of our study was to summarize our experience with gentamycin-collagen sponge (GCS) in multi-component prevention strategy of cardiac implantable electronic device infection.
Methods: We retrospectively analyzed medical records of 312 consecutive patients who underwent CIED-related surgery and had at least 6 months follow-up. All the individuals had GCS applied during surgery. An incidence of CIEDs-related infection in our group was compared to risk level calculated according to commonly used scores. An analysis of cost-effectiveness was also performed.
Results: Incidence of CIED-related infection, defined as primary endpoint, occurred relatively rarely (0.33%) as compared to the infection risk calculated according to commonly used scores (PADIT — 0.83%; CIED-AI — 0.90% or Mittal score — 1.00%; P <0.001 — for all). We did not record any complication related to GCS. We analyzed cost-effectiveness of our GCS-based approach, which appeared to be financially beneficial (number needed to treat 149–200; difference of CIED infection treatment cost and GCSs price was 5093–26525 $).
Conclusions: We conclude that: 1) use of GCS to reduce CIEDs infections is feasible and safe; 2) our multi-component prevention strategy involving the GCS application seems to significantly reduce rate of CIED infection and it is cost-effective.

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Keywords

antibiotic prophylaxis, cardiac implantable electronic device, gentamycin-collagen sponge, infection

About this article
Title

The safety, efficacy and cost-effectiveness of gentamycin-collagen sponge in multi-component prevention strategy of cardiac implantable electronic device infections — the single-center experience

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-08-09

DOI

10.33963/KP.a2021.0089

Pubmed

34392518

Keywords

antibiotic prophylaxis
cardiac implantable electronic device
gentamycin-collagen sponge
infection

Authors

Krzysztof Kaczmarek
Aleksander Strzelecki
Paweł Ptaszyński
Jerzy K Wranicz
Iwona Cygankiewicz

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