Role of antibiotic envelopes in preventing cardiac implantable electronic device infection: A meta‐analysis of 14 859 procedures

INTRODUCTION: We conducted an updated meta‐analysis assessing the role of antibiotic envelopes in preventing Cardiac implantable electronic devices (CIED)‐related infections as compared to standard infection prevention strategies. METHODS: A systematic search was conducted on Medline/PubMed and EMBASE/Ovid database. We used Mantel‐Haenszel method with fixed‐effect model to compute risk ratio (RR) with 95% confidence interval (CI). We also performed subgroup and trial sequential analysis on the data. RESULTS: Antibiotic envelope reduced the risk of both all infections [RR: 0.41, CI: 0.31‐0.54, P < .05, I (2) = 75%, χ (2) P < .05] and major infections [RR: 0.48, CI: 0.32‐0.70, P < .05, I (2) = 60%, χ (2) P = .04]. CONCLUSION: Prophylactic use of antibiotic envelopes as an adjuvant therapy to standard infection prevention strategies, helps in reducing the risk of CIED infections.