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September 10, 1973

Prevention of Infection of Pacemaker Pocket

JAMA. 1973;225(11):1388. doi:10.1001/jama.1973.03220390062023

To the Editor.—  Infection following pacemaker insertion usually requires removal of the unit, with reimplantation at another site.1,2 A review of our experience with 176 battery implants indicates that preloading with antibiotics is a helpful preventive measure.One hundred thirty-seven patients have received 195 new or replacement pacemaker batteries on the University of Tennessee Thoracic Surgery Service from 1966 to 1973, with 176 implants available for analysis.The most commonly used antibiotics, cephalothin sodium, cephalexin, and nafcillin were employed to support 149 of the 176 implants. Nine patients received no antibiotics, and the rest were divided rather equally among several categories. None of the 13 patients requiring early re-opening of the pacemaker pocket for lead repositioning within one week showed infection.

Results.—  Four of the seven pocket infections occurred in patients not receiving antibiotics, and there were no infections in the group that received both preoperative and postoperative coverage.