Because the bulk of infections are due to staphylococcal species, and some of them will be oxacillin resistant, vancomycin should be administered initially as empirical antibiotic coverage until microbiological results are known. Patients with infections due to oxacillin-susceptible staphylococcal strains can be given cefazolin or nafcillin alone with discontinuation of vancomycin. Vancomycin should be continued in patients who are not candidates for -lactam antibiotic therapy and those with infections due to oxacillin-re- sistant staphylococci. Pathogen identification and in vitro sus- ceptibility testing can be used to direct treatment in the minority of patients with nonstaphylococcal CIED infections. There are no clinical trial data to define the optimal duration of antimicrobial therapy for CIED infections, regard- less of the extent of infection, or to determine when conver- sion to an oral agent is appropriate once complete device removal has been achieved. Factors that influence medical decision making include the extent of device infection, the causative organism, the presence and duration of bloodstream infection, and associated complications such as valvular involvement, septic thrombophlebitis, or osteomyelitis (Fig- ure 2A). Blood cultures should be obtained from all patients after device removal. When CIED infection is limited to the pocket site, 7 to 10 days of therapy after device removal is reasonable if the presentation is device erosion without inflammatory changes; otherwise, 10 to 14 days of antimi- crobial treatment is recommended. Therapy can be switched to an oral regimen once susceptibility results are known if there is an oral agent available that is active against the pathogen and the infected CIED has been removed. At least 2 weeks of parenteral therapy is recommended after extraction of an infected device for patients with bloodstream infection. 