A meta-analysis of antibacterial envelope use in prevention of cardiovascular implantable electronic device infection. (May 2017)

• Record Type: Journal Article
• Authors: Ali, Sajid; Kanjwal, Yousuf; Bruhl, Steven R.; Alo, Mohammed; Taleb, Mohammed; Ali, Syed S.; Kabour, Ameer; Khawaja, Owais
• Is Part Of: Therapeutic advances in infectious disease. Volume 4:Number 3(2017:May)
• Page Start: 75
• Page End: 82
• Publication Date: 2017-05
• Subjects: cardiac implantable electronic device -- epidemiology -- infection -- TYRX envelope; Communicable diseases -- Treatment -- Periodicals; Infection -- Treatment -- Periodicals; 616.905
• DOI: 10.1177/2049936117702317
• Languages: English
• ISSNs: 2049-9361

Abstract

Objectives: Cardiac implantable electronic device (CIED) infection has been a major clinical problem in addition to being a major financial burden. In spite of antimicrobial prophylaxis, CIED infection rates have been increasing disproportionately. We therefore conducted this meta-analysis to assess the role of TYRX antibiotic envelope for the prevention of CIED infection. Methods: Using extensive online search, we conducted a meta-analysis of studies reporting CIED infections with versus without the use of TYRX antibiotic envelope. A random-effect model was used, and between studies heterogeneity was estimated with I 2 . All analyses were performed with RevMan (version 5.0.20). Results: Five cohort studies were included in this meta-analysis. The pooled odds ratio (OR) of included studies was 0.29 [95% confidence interval (CI): 0.09–0.94; p < 0.004]. There was evidence of heterogeneity with I 2 of 58%. There was also evidence of publication bias on funnel plot analysis. On sensitivity analysis, no statistically significant difference was noted when stratified by study design or duration of follow-up. Conclusion: The results of our study demonstrate a significant beneficial effect of TYRX antibiotic envelope for the prevention of CIED infections.