Permanent Pacemaker insertion/ implantable cardiac devices - Antibiotic Prophylaxis recommendations (52)


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A guideline is intended to assist healthcare professionals in the choice of disease-specific treatments.

Clinical judgement should be exercised on the applicability of any guideline, influenced by individual patient characteristics. Clinicians should be mindful of the potential for harmful polypharmacy and increased susceptibility to adverse drug reactions in patients with multiple morbidities or frailty.

If, after discussion with the patient or carer, there are good reasons for not following a guideline, it is good practice to record these and communicate them to others involved in the care of the patient.


Single dose, IV prophylaxis ≤ 60 minutes prior to skin incision/ intervention. 

MRSA:  decolonise prior to procedure as per NHS GGC infection control .guidelines.

CPE carriers: If identified as a Carbapenamase producing Enterobacteriaceae carriers contact microbiology.

Procedure Recommended Antibiotic Prolonged Surgery > 4 or > 8 hours
Insertion of permanent pacemaker / implantable cardiac devices

400 mg Teicoplanin

≤ 40 Kg  

800mg Teicoplanin  >40 Kg

Give 400 -800 mg teicoplanin by slow intravenous injection over 3-5 minutes.

No repeat dosing of teicoplanin.

Last reviewed: 10 May 2022

Next review: 31 May 2025

Author(s): Ysobel Gourlay

Version: 7

Author Email(s): [email protected]

Approved By: Antimicrobial Utilisation Committee

Document Id: 52