Key result
Complete CIED removal and 6-week antibiotics yields zero relapses and similar mortality between pocket and systemic infections.
Why the study?
Does complete device removal and 6-week antibiotic treatment result in safe long-term outcomes for patients with systemic or pocket CIED infections?
Cohort (n=71)
Does complete device removal and 6-week antibiotic treatment result in safe long-term outcomes for patients with systemic or pocket CIED infections?
p-value: p=0.48
Complete device removal followed by a 6-week course of antibiotics is safe and effective for both systemic and pocket CIED infections, with no relapses observed.
May support complete CIED removal plus 6-week antibiotics; leaves open randomized confirmation of optimal duration and equivalence.
OBJECTIVE: Cardiovascular implantable electronic device (CIED) infections are increasing in numbers. The objective was to review the clinical presentation and outcome in patients affected with CIED infections with either local pocket or systemic presentation. DESIGN: All device removals due to CIED infection during the period from 2005 to 2012 were retrospectively reviewed. CIED infections were categorized as systemic or pocket infections. Treatment included complete removal of the device, followed by antibiotic treatment of six weeks. RESULTS: Seventy-one device removals due to infection (32 systemic and 39 pocket infections) were recorded during the study period. Median follow-up time was 26 (IQR 9-41) months, 30 day and 12 month mortality were 4% and 14%, respectively. There was no long-term difference in mortality between patients with pocket vs. systemic infection (p = 0.48). During follow-up no relapses and two cases of new infections were noted (2.8%). CONCLUSIONS: CIED infection with systemic or pocket infection was difficult to distinguish in clinical presentation and outcome. Complete device removal and antibiotic treatment of long duration was safe and without relapses.
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Ihlemann et al. (2015) conducted a cohort in Cardiovascular implantable electronic device (CIED) infections (n=71). Complete device removal and antibiotic treatment vs. Pocket vs. systemic infection presentation was evaluated on Long-term mortality difference between pocket vs. systemic infection (p=0.48). Complete device removal and 6-week antibiotics for CIED infections resulted in no relapses and no long-term mortality difference between pocket and systemic presentations (p=0.48).
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