One stage extraction and reimplantation of ICD/PM in patients with CIED related endocarditis and spondiloscitis due to E. faecalis treated with double beta-lactam combination: ampicillin plus ceftobiprole.

Abstract

The time of re-implantation of removed CIED for local infection or endocarditis has been debated because no randomized studies are available. Many authors prefer to delay reimplantation to the time of blood culture negative or clinical stability. In this case report we describe the case of E. faecalis CIED endocarditis treated with the combination ampicillin plus ceftobiprole and one-stage removal and re-implantation with early follow-up without relapse of infection. In case of E. faecalis infection, we hypothesize that ampicillin plus ceftobiprole combination might have bactericidal and anti-biofilm activity, therefore allowing one state re-implantation without relapse.