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 instituti...

Full description

Saved in:
Bibliographic Details
Main Authors: Gomes Botelho Quintas, Bruna (Author) , Geis, Nicolas (Author) , Leuschner, Florian (Author) , Meder, Benjamin (Author) , Konstandin, Mathias (Author) , Katus, Hugo (Author) , Bekeredjian, Raffi (Author)
Format: Article (Journal)
Language:English
Published: 05 November 2018
In: Journal of interventional cardiology
Year: 2018, Volume: 31, Issue: 6, Pages: 885-890
ISSN:1540-8183
DOI:10.1111/joic.12567
Online Access:Verlag, Volltext: https://doi.org/10.1111/joic.12567
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/joic.12567
Get full text
Author Notes:Bruna Gomes, Nicolas A. Geis, Florian Leuschner, Benjamin Meder, Mathias Konstandin, Hugo A. Katus, Raffi Bekeredjian
Description
Summary: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.
Item Description:Gesehen am 10.05.2019
Physical Description:Online Resource
ISSN:1540-8183
DOI:10.1111/joic.12567