CRMD Infection Pathogens & Prophylaxis
* Coagulase (-) Staphylococcus (e.g. S.epidermidis) and S. aureus are responsible for > 70% of CRMD Infections
• …and Coagulase (-) Staphylococcus and S. aureus are increasingly resistant to methicillin (cefazolin): 1-3
• There are no AHA/ACC/HRS Guidelines for antibiotic prophylaxis to prevent CRMD-related infections.
• Although systemic antibiotic prophylaxis can significantly reduce CRM-related infections 4 …cefazolin and vancomycin
have important clinical deficiencies when used as a single agent. 1-3
• Cefazolin and vancomycin are rarely used in combination
• Substantial overlap (both have activity against gram (+) organisms)
• Neither has strong profile against gram (-) organisms
• Vancomycin has poor tissue penetration
*Source: Meta-analysis of 7 Studies Enrolling 1995-2006:
DaCosta et al, Circulation 1998 97(18), 1791; Dy Chua et al, Ann Intern Med 2000 133(8), 604;
Klug et al, Circulation 2007 116, 1349; Sohail et al, J Am Coll Cardiol 2007 49(18), 1851;
Catanchin et al, Heart Lung Circ 2007 16(16), 434;
Baman et al, Circ Arrhythmia Electrophysiol 2009 2, 129;
Lekkerkerker et al, Heart 2009 January 95, 715.
1. Wisplingkoff et al, SCOPE Study Group. Clinical Infectious Disease 2004 39(3), 309.
2. NNIS System Report: Am J Infect Control 2004 32(8), 470.
3. Gilbert et al. The Sanford Guide to Antimicrobial Therapy 2008, (38th edition).
4. de Oliveira et al, Circ Arrhythmia Electrophysiol 2009 2, 29.
*AIGISRx reduction in infection is based on in vitro and in vivo data. Use of AIGISRx in contaminated wounds is not recommended. The device is not indicated for the treatment of infection.
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