Continuous, In Situ Targeted, Ultrahigh-Concentration Antibiotics for Infections from Cardiac Implantable Electronic Devices: The First Taiwan Case Series.

According to current scientific consensus, the definitive treatment for cardiac implantable electronic device (CIED)-related infection is complete removal of the device with adjunctive antibiotic therapy. However, this approach carries the risk of major complications and mortality during or after lead extraction. Conservative treatment with continuous, in situ targeted, ultrahigh-concentration antibiotics (CITAs) to treat localized CIED infection has been shown to have a high success rate without major complications in high-risk patients. Herein, we describe the details of CITA treatment and our experience with four patients, three of whom successfully avoided the need for lead extraction. CITAs represent a promising alternative approach to lead extraction in patients with localized CIED infections. However, further prospective studies are necessary to definitively establish its effectiveness and potentially modify current consensus recommendations.