Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: Despite the fact that infection remains a major complication of continuous-flow left ventricular assist device (CF-LVAD) therapy, an optimal antimicrobial surgical infection prophylaxis (SIP) regimen has not been established. The purpose of this study was to evaluate the efficacy of single- (SD) and multi-drug (MD) SIP regimens on clinical outcomes in CF-LVAD patients, including device-related infections.
Methods: Electronic search was performed to identify all studies reporting SD and MD SIP regimen in patients undergoing CF-LVAD implantation. Identified articles were assessed for inclusion and exclusion criteria, and pooled for systematic review and meta-analysis.
Results: Total of six articles with 883 patients were pooled for the analysis. Of these, 358 (41%) patients received SD while 525 (59%) patients received MD prophylaxis. Mean age of patients at implantation was 55 years and 20% were female. Average follow up time post LVAD implantation were comparable between the two groups [MD: 12 months (95% CI 0-27 months); SD: 9 months (95% CI 0-26 months), p=0.99]. Average time to infection following CF-LVAD implantation was 14 months (95% CI 0-140 months) in the MD group, and 4 months (95% CI 0-172 months) in the SD group (p=0.99). No significant difference was found in the number of LVAD device-specific infections [MD: 17% (95% CI 10%-28%); SD: 9% (95% CI 4%-20%), p=0.20], driveline infections [MD 15% (95% CI 10%-23%); SD 7% (95% CI 3%-17%), p=0.12] and pump-pocket infections [MD: 3% (95% CI 1%-8%); SD: 2% (95% CI 1%-6%), p=0.51] between the two groups. Overall survival following CF-LVAD implantation were comparable between the two groups at 90 days [SD: 90% (95% CI 85%-93%); MD: 82% (95% CI 76%-92%), p=0.27] and 1 year [SD: 78% (95% CI 72%-84%); MD: 64% (95% CI 12%-96%), p=0.6].
Conclusion: Our analysis showed no clear advantage to use a MD regimen over a SD regimen in surgical infection prophylaxis. Furthermore, there were no significant differences in the frequency of LVAD device infections and post LVAD implantation survival.
CITATION INFORMATION: Patel S., Choi J., Moncho Escrivà E., Rizvi S., Samuels L., Luc J., Morris R., Massey H., Tchantchaleishvili V., Aburjania N. Single vs. Multi-Drug Antibiotic Prophylaxis for Continuous-Flow Left Ventricular Assist Device Implantation: A Systematic Review and Meta-Analysis Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Patel S, Choi J, Escrivà EMoncho, Rizvi S, Samuels L, Luc J, Morris R, Massey H, Tchantchaleishvili V, Aburjania N. Single vs. Multi-Drug Antibiotic Prophylaxis for Continuous-Flow Left Ventricular Assist Device Implantation: A Systematic Review and Meta-Analysis [abstract]. https://atcmeetingabstracts.com/abstract/single-vs-multi-drug-antibiotic-prophylaxis-for-continuous-flow-left-ventricular-assist-device-implantation-a-systematic-review-and-meta-analysis/. Accessed January 22, 2020.
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