Why the study?
CIED infections cause significant morbidity and mortality with extraction as traditional mainstay, but continuous in situ-targeted ultrahigh antibiotic concentrations (CITA) may offer an alternative.
Continuous in situ targeted antibiotics (CITA) may serve as a viable alternative to device extraction for selected cases of CIED pocket perforation.
CITA may spare extraction in select CIED perforations; leaves open need for prospective trials before any practice change.
CIED infections are a dreaded complication associated with significant morbidity and mortality and the mainstay of treatment has traditionally been extraction. A recent cohort study suggested that continuous, in situ-targeted, ultrahigh concentrations of antibiotics (CITA) delivered into the CIED pocket may be a viable alternative to extraction in selected cases. We highlight two cases of device perforation which were successfully treated with this technique.
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Leong et al. (2023) studied this question.
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