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Periprocedural systemic antimicrobial prophylaxis is employed to reduce risk for infection associated with implantable cardiac devices (ICD). To examine whether local antimicrobials at the site of ICD placement further reduce this risk, researchers randomized 6983 patients (72% male; mean age, 70) who were receiving an ICD to have either standard-of-care antibiotic prophylaxis (control) or standard prophylaxis plus an absorbable minocycline- and rifampin-impregnated envelope that held the ICD once placed. The primary endpoint of this multicenter, manufacturer-sponsored trial was ICD infection within 12 months after implantation.
Twenty-five (0.7%) of 3490 envelope recipients developed infection versus 42 (1.2%) of 3485 control patients, a si…