Prevention of Arrhythmia Device Infection Trial (PADIT)
|Study Design:||Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Prevention
|Official Title:||Prevention of Arrhythmia Device Infection Trial (PADIT) Cluster Crossover Study|
- Hospitalization attributed to device infection [ Time Frame: Evaluation is one year post patient's procedure ]
- 1. Proven device infection not requiring surgical intervention (medically treated device infection). [ Time Frame: Up to one year post procedure ]
- 2. Any treatment with antibiotics for suspected device infection. [ Time Frame: Up to one year post procedure ]
- 3. Antibiotic-related adverse events including culture or antigen proven C. difficile infection. [ Time Frame: Up to one year post procedure ]
- 4. Prolongation of hospitalization due to proven or suspected adverse events from the antibiotic therapy. [ Time Frame: Up to one year post procedure ]
- Cost benefit analysis [ Time Frame: At completion of data collection period ]
- 6. Rate of device/lead extraction 12 months post patient's procedure (regardless of the cause). [ Time Frame: Up to one year post procedure ]
|Study Start Date:||December 2012|
|Estimated Study Completion Date:||January 2018|
|Estimated Primary Completion Date:||September 2017 (Final data collection date for primary outcome measure)|
Preoperative Antibiotics: Cefazolin preoperative, vancomycin in penicillin allergic patients.
Other Name: Cefazolin
Preoperative antibiotics (Cefazolin and Vancomycin) Bacitracin pocket wash and 2 days of oral Cefalexin post operative.
Single dose of Cefazolin and Vancomycin preoperatively, bacitracin wash and cefalexin post operative.
This is a randomized prospective cluster crossover trial to track outcomes of high infection risk patients undergoing arrhythmia device procedures. Centres will be randomized to either conventional antibiotic therapy or incremental antibiotic therapy. Patients will not be randomized. Centres will be randomized to one therapy and then cross over to the next after 6 months. At one year they will randomize again and then cross over for the final time at 18 months. During each treatment period the randomized antibiotic therapy will be used on all centre patients undergoing a device implant procedure.
Ethics approval has been obtained in all sites for waiver of consent with notification of the study (i.e. data collection is taking place to track infection rates). A third of sites obtain consent after the procedure for collection of data (but not for care, since either arm is the standard of care).
Please refer to this study by its ClinicalTrials.gov identifier: NCT01628666
|Coordinating Centre: Population Health Research Institute|
|Hamilton, Ontario, Canada, L8L 2X2|
|Principal Investigator:||Andrew Krahn, MD||University of British Columbia|