What is the current scientific basis for the use of prophylactic antibiotics before routine invasive dental, gastrointestinal, or genitourinary procedures to prevent CIED infection?
There is currently no scientific basis for the use of prophylactic antibiotics before routine invasive dental, gastrointestinal, or genitourinary procedures to prevent CIED infection. A review of the literature from 1950 to 2007 for publications on cardiac electrophysiological device infections reveals more than 140 articles, none of which report hematologic infection from dental, gastrointestinal, genitourinary, dermatologic, or other procedures. The predominance of staphylococci as pathogens in CIED infections rather than oral flora98 suggests that antibiotic prophylaxis for dental procedures is of little or no value.1,89,99,100 In the rare event of a device infection due to an oral pathogen, it is most likely to have arisen from a bacteremia from a common daily event such as toothbrushing or chewing food.98