The physician recommended replacing the pacemaker because it was likely serving as the source of recurrent bacteremia. In some cases, bacteria can form a biofilm on the surface of medical devices, including pacemakers. This biofilm can act as a source of persistent infection, leading to recurrent bacteremia even after antibiotic therapy.
Despite receiving antibiotic therapy for the initial episode of streptococcal bacteremia, the bacteria may have remained on the surface of the pacemaker or in the surrounding tissue. This can result in a new infection and subsequent recurrence of bacteremia.
Replacing the pacemaker removes the potential source of infection, allowing for the elimination of the persistent bacteria. By removing the infected pacemaker and implanting a new one, the patient has a higher chance of clearing the infection and preventing further episodes of bacteremia.
It's important to note that the decision to replace the pacemaker would be based on the specific circumstances of the patient's case and the physician's assessment of the risk and benefits of the procedure. The physician would consider factors such as the severity of the infection, the patient's overall health, and the potential complications associated with pacemaker replacement.