Cardiac
Prophylactic antibiotics can decrease the incidence of infection after cardiac surgery, and intraoperative redosing has been associated with adecreased risk of postoperative infection in procedures lasting >400 minutes (G Zanetti et al, Emerg Infect Dis 2001; 7:828). Antimicrobial prophylaxis for prevention of device-related infections has not been rigorously studied. It is, however, generally given before placement of electrophysiologic devices, ventricular assist devices, ventriculoatrial shunts and arterial patche. A meta-analysis of seven randomized studies of antimicrobial prophylaxis for implantation of permanent pacemakers showed a statistically significant reduction in the incidence of wound infection, inflammation or skin erosion.