NI Qiuming,Lin Miao,JI Xiaojun, et al. A comparative study of amoxicillin sulbactam and cefuroxime in the prevention of infection during periop-erative period of permanent pacemaker[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2020, 50(4): 312-316.
Abstract：Objective: To investigate the effectiveress and safety of different antibiotics in the prevention of infection during perioperative period of permanent pacemaker, for the sake of reasonable selection of antibiotics in clinical practice. Methods: From August 2015 to August 2017, 120 patients with permanent pacemaker implantation in Wenzhou Central Hospital were randomly divided as experimental group and control group, each group consisting of 60 patients. Amoxicillin sulbactam (1.5 g intravenous drip) was used half an hour before operation in experimental group, and cefuroxime (1.5 g intravenous drip) was used in control group to prevent infection within 24 hours after operation. In both groups, body temperature, white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT) were measured before operation, 48 hours and 72 hours after operation and the indexes were compared between the two groups. The incidence of fever, pacemaker bag infection, bag hematoma, pulmonary infection, infective endocarditis, pathogens, adverse reactions of antibiotics and cost of antibiotic were compared within 7 days after operation. Results: There was no significant difference in body temperature, WBC, CRP and PCT between the two groups before operation (P>0.05). The body temperature, WBC, CRP and PCT of the experimental group at 48 and 72 hours after operation were significantly lower than those of the control group (P<0.05). The incidence of fever within 7 days in the experimental group was lower than that of the control group (1.67% vs. 11.67%, P<0.05). The incidence of pacemaker bag infection in the experimental group was lower than that in the control group (3.33% vs. 13.33%, P<0.05). The incidence of pocket hematoma, pulmonary infection and infectious endocarditis was not significantly different between the two groups (P>0.05). In the control group, 1 case of severe infection required removal of pacemaker and electrodes, but none in the experimental group. Staphylococcus aureus was the most common pathogen of pacemaker infection in the two groups, while Staphylococcus epidermidis, Escherichia coli and Klebsiella pneumoniae were cultured in the control group. No adverse reactions were found in the experimental group. There was no significant difference between the two groups (P>0.05). The cost of antibiotics in the experimental group was less than that in the control group (P<0.05). Conclusion: Amoxicillin sulbactam is superior to cefuroxime in the prevention of infection during perioperative period of permanent pacemaker implantation with lower incidence of infection, less cost and comparable adverse reactions to cefuroxime.
