Periprocedural antibiotic treatment in transvascular aortic valve replacement

BACKGROUND To date, there are no guidelines recommending a specific prophylactic antibiotic treatment in transcatheter aortic valve replacement (TAVR). The aim of this study is to evaluate clinical data after TAVR with different periprocedural antibiotic regimens. METHODS In May 2015 the institutional rules for periprocedural antibiotic prophylaxis were changed from 3 days to 1 day. Thus, a total of 450 consecutive TAVR patients between February 2014 and June 2016 were classified into two intention-to-treat groups: patients receiving a 1-day Cefuroxime prophylaxis (N = 225); patients receiving a 3-day Cefuroxime prophylaxis (N = 225). RESULTS One-day Cefuroxime regimen was not associated with shorter hospitalization (3-day Cefuroxime 9 ± 4.7 vs 1-day Cefuroxime 8.9 ± 4.0; P = 0.87). Incidence of diarrhea (26.2% vs 18.2%; P = 0.04) and Clostridium difficile infections (4% vs 0.4%; P = 0.01) were significantly higher in the 3-day group. No endocarditis was registered after 1 year follow-up. There was no difference in 30-day overall mortality rate, major vascular complications, bleeding complications, pacemaker-implantation rate, paravalvular regurgitation, or acute kidney injury between patients groups. CONCLUSION Three-day Cefuroxime prophylaxis does not seem to be advantageous compared to a shorter 1-day regimen, but even shows a significantly higher incidence of diarrhea and Clostridium difficile infection.

• Publication year

  2018

• Venue

  Journal of interventional cardiology

• Publication date

  2018-11-05

• Fields of study

  Medicine

• Identifiers
  DOI 10.1111/joic.12567PMID 30397939
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Efficacy of postoperative prophylactic antibiotics in reducing permanent pacemaker infections

  2017cited by this paper
• 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

  2017cited by this paper
• Incidence and clinical impact of infective endocarditis after transcatheter aortic valve implantation.

  2016cited by this paper
• The future of transcatheter aortic valve implantation.

  2016cited by this paper
• The extent of aortic annulus calcification is a predictor of postprocedural eccentricity and paravalvular regurgitation: a pre- and postinterventional cardiac computed tomography angiography study.

  2015cited by this paper
• Transcatheter Aortic Valve Implantation - Yesterday, Today and Tomorrow.

  2015cited by this paper
• Infective Endocarditis After Transcatheter Aortic Valve Implantation: Results From a Large Multicenter Registry

  2015cited by this paper
• TAVR-associated prosthetic valve infective endocarditis: results of a large, multicenter registry.

  2014cited by this paper
• Transcatheter aortic valve replacement: current perspectives and future implications

  2014cited by this paper
• Objective quantification of aortic valvular structures by cardiac computed tomography angiography in patients considered for transcatheter aortic valve implantation

  2013cited by this paper
• How Long Should Prophylactic Antibiotics be Prescribed for Permanent Pacemaker Implantations? One Day versus Three Days.

  2013cited by this paper
• Antibiotic prophylaxis in cardiac surgery: systematic review and meta-analysis.

  2012cited by this paper
• Transcatheter aortic-valve replacement for inoperable severe aortic stenosis.

  2012cited by this paper
• Host and pathogen factors for Clostridium difficile infection and colonization.

  2011cited by this paper
• Prospective derivation and validation of a clinical prediction rule for recurrent Clostridium difficile infection.

  2009cited by this paper
• Clostridium difficile--more difficult than ever.

  2008cited by this paper

• Infective Endocarditis after Transcatheter Aortic Valve Replacement: Challenges in the Diagnosis and Management

  2023cites this paper
• Endocarditis after Transcatheter Aortic Valve Replacement

  2023cites this paper
• Early infections after successful transcatheter aortic valve replacement are associated with increased short- and long-term mortality: A single-center study.

  2021cites this paper
• Infective endocarditis in patients who have undergone transcatheter aortic valve implantation: a review.

  2020cites this paper
• Transcatheter Aortic Valve Replacement Associated Infective Endocarditis: A Clinical Update

  2020cites this paper