Key result
High-dose IV flucloxacillin plus pacemaker removal is linked to recovery in pacemaker-related staphylococcal septicemia.
Why the study?
Staphylococcal septicaemia in patients with permanent and temporary endocardial pacemakers requires evaluation of treatment approaches and outcomes.
Does high dose intravenous flucloxacillin combined with pacemaker removal improve recovery in patients with staphylococcal septicaemia due to endocardial pacemakers?
Observational (n=24)
Does high dose intravenous flucloxacillin combined with pacemaker removal improve recovery in patients with staphylococcal septicaemia due to endocardial pacemakers?
High dose intravenous flucloxacillin combined with pacemaker removal is effective for staphylococcal septicaemia in pacemaker patients, and medical therapy alone may eradicate infection in some cases with retained tips.
Answers are grounded in this paper and cite their sources.
Should not yet change practice for pacemaker staphylococcal septicaemia; leaves open optimal device management and antibiotic duration.
Twenty-four patients with staphylococcal septicaemia due to permanent (14) and temporary (10) endocardial pacemakers were reviewed. With permanent pacemakers local inflammation was usually present and the onset of septicaemia rapid. If patients were treated with high dose intravenous flucloxacillin combined with removal, recovery was usual. In patients with retained endocardial tips (6) we eradicated infection with medical treatment alone in four cases. We would advocate antistaphylococcal prophylaxis for patients undergoing revision in the presence of local inflammation and high dose intravenous flucloxacillin plus a second anti-staphylococcal antibiotic (e.g. gentamicin) in patients with septicaemia and a pacemaker in situ.
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Smyth et al. (1989) conducted an observational in Staphylococcal septicaemia due to endocardial pacemakers (n=24). High dose intravenous flucloxacillin combined with pacemaker removal was evaluated on Recovery from infection. In 24 patients with pacemaker-related staphylococcal septicaemia, treatment with high-dose intravenous flucloxacillin combined with pacemaker removal usually resulted in recovery.
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