**Author details**

#### Joern Schmitt

An interesting, newly developed approach of device coatings seems to be able to control local bacterial growth and thus is supposed to be able to prevent system infections [28, 29]. The study by Matl et al. describes the use of gentamycin and teicoplanin in a lipidbased drug delivery-system which was able to deliver high local concentrations over 96h and inhibit completely the growth of S. aureaus in vivo [28]. Wong et al. published data on a dual layer device coating, consisting of gentamycin to control local colonization/ infection and diclofenac to control local inflammation due to tissue injury on top of a mi‐ crobicidal base film [29]. In vitro they could show excellent results in terms of S. aureus control (figure 1). No data on extended in vivo use of any coating is yet available but

**Figure 1.** Media-borne assay with *S. aureus* with increasing time of incubation in bacterial solution; top row shows bare substrates completely colonized by bacteria (light beige colored dots); bottom row shows (DMLPEI/PAA)10 films with degradable top films completely eroded with no sign of colonization by bacteria (black colored substrate). From

Concerning the severe consequences arising from an infected implanted pacemaker or defibrillator and the data available there should be no discussion on the use of preven‐ tive perioperative antibiotics. Randomized data were reported only on the use of a single shot cephfazolin although some other antibiotic agents are supposed to be equally effi‐ cient as almost every perioperative device infection is caused by staphylococci or strepto‐ cocci. In some hospitals with a high rate of methicillin resistant staphylococci vancomycin may be the most proper choice. There is an interesting new approach with

the idea and techniques are promising.

116 Cardiac Defibrillation

Wong et al., Journal of the American Chemical Society 2010.

**3. Conclusion / recommendation**

coated devices that needs further evaluation.

University of Giessen and Marburg, Medical Clinic I, Department of Cardiology, Giessen, Germany and Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nau‐ heim,, Germany
