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BERTAGLIA, E., ET AL.: Antibiotic Prophylaxis with a Single Dose of Cefazolin During Pacemaker Implantation: Incidence of Long-Term Infective Complications. Objective: Systemic and localized infections related to permanent pacemaker implantation are not common, but are serious and potentially lifethreatening complications. The aims of this prospective observational study were: (1) to assess the safety and long-term efficacy of a simplified scheme of antibiotic prophylaxis, and (2) to identify the predictors of long-term infective complications, in patients undergoing pacemaker implantation or replacement. Methods andResults: FromOctober 1998 to July 2001, 852 patients (mean age 77.0± 9.2 years; 474men) who underwent new permanent pacemaker implantation (69.6%) or pulse generator replacement (30.4%) received amini-bag of 2 g of cefazolin diluted in 50mL of saline solution, administered intravenously in 20 minutes before the beginning of the procedure. Early (within 2months of implantation) and late major and minor infective complications were recorded. During the earlier phase,minor complications were observed in 9 patients (1%). During the long-term phase of the surveillance (mean 25.6 ± 11.0 months, range 12– 55 months) major infective complications were observed in 6 patients (0.7%). On multivariate analysis, no clinical or procedural variable predicted the occurrence of long-term infective complications. Conclusions: Our data indicate the safety and efficacy of a single, intravenous 2 g dose of cefazolin in preventing infective complications related to pacemaker implantation or replacement. No clinical or procedural variable predicted the occurrence of long-term infective complications. (PACE 2006; 29:29–33)