Modification and duration of therapy for cardiac implantable electronic device lead endocarditis

For cardiac implantable electronic device lead endocarditis, modify therapy based on the results of culture and susceptibility testing.

Continue antibiotic therapy for 4 to 6 weeks after the cardiac implantable electronic device and leads are removed – seek expert advice. The duration of therapy depends on:

• whether native or prosthetic cardiac valves are additionally involved
• the initial clinical response to antimicrobials
• the organisms involved
• the presence of extracardiac infection.

Cure of the infection cannot be assured if the cardiac implantable electronic device is not removed – this should only be considered in rare cases. Seek expert advice for long-term antibiotic choice and duration.