Periprocedural antibiotic treatment in transvascular aortic valve replacement

• Verfasst von: Gomes Botelho Quintas, Bruna [VerfasserIn]
• Verfasst von: Geis, Nicolas [VerfasserIn]
• Verfasst von: Leuschner, Florian [VerfasserIn]
• Verfasst von: Meder, Benjamin [VerfasserIn]
• Verfasst von: Konstandin, Mathias [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Bekeredjian, Raffi [VerfasserIn]
• Titel: Periprocedural antibiotic treatment in transvascular aortic valve replacement
• Verf.angabe: Bruna Gomes, Nicolas A. Geis, Florian Leuschner, Benjamin Meder, Mathias Konstandin, Hugo A. Katus, Raffi Bekeredjian
• E-Jahr: 2018
• Jahr: 05 November 2018
• Umfang: 6 S.
• Fussnoten: Gesehen am 10.05.2019
• Titel Quelle: Enthalten in: Journal of interventional cardiology
• Ort Quelle: London : Hindawi, 1988
• Jahr Quelle: 2018
• Band/Heft Quelle: 31(2018), 6, Seite 885-890
• ISSN Quelle: 1540-8183
• DOI: doi:10.1111/joic.12567
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: antibiotic prophylaxis
• Sach-SW: aortic stenosis
• Sach-SW: endocarditis
• Sach-SW: TAVR
• K10plus-PPN: 166515943X

Abstract

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.