cefazolin + vancomycin + bacitracin + cephalexin

This is an incremental antibiotic prophylaxis regimen evaluated in the PADIT (Prevention of Arrhythmia Device Infection Trial) for the prevention of cardiac implantable electronic device (CIED) infections. The regimen consists of preoperative administration of intravenous cefazolin and vancomycin, an intraoperative pocket wash with bacitracin, and a two-day postoperative course of oral cephalexin. It was developed by the Population Health Research Institute (PHRI) to reduce infection rates in high-risk patients undergoing arrhythmia device procedures compared to conventional single-dose cefazolin prophylaxis. The PADIT trial was a large-scale cluster crossover study that found no significant reduction in CIED infections with this incremental approach compared to conventional therapy.

Other names

Incremental antibiotic therapyPADIT incremental antibiotic prophylaxisIncremental-Population Health Research Institute-cardiac implantable electronic device infection