Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis
Por:
Camazon, NV, Mateu, L, Cediel, G, Escola-Verge, L, Fernandez-Hidalgo, N, Ferrer, MG, Rodriguez, MTP, Cuervo, G, Aragon, RN, Llibre, C, Sopena, N, Quesada, MD, Berastegui, E, Teis, A, Ayerbe, JL, Junca, G, Gual, F, Sistach, EF, Vivero, A, Reynaga, E, Perez, MH, Guijosa, CM, Pedro-Botet, L and Bayes-Genis, A
Publicada:
1 jul 2021
Ahead of Print:
25 may 2021
Resumen:
Background: To date, there is little information regarding management of patients with infective endocarditis (IE) that did not undergo an indicated surgery. Therefore, we aimed to evaluate prognosis of these patients treated with a long-term antibiotic treatment strategy, including oral long term suppressive antibiotic treatment in five referral centres with a multidisciplinary endocarditis team.
Methods: This retrospective, multicenter study retrieved individual patient-level data from five referral centres in Spain. Among a total of 1797, 32 consecutive patients with IE were examined (median age 72 years; 78% males) who had not undergone an indicated surgery, but received long-term antibiotic treatment (LTAT) and were followed by a multidisciplinary endocarditis team, between 2011 and 2019. Primary outcomes were infection relapse and mortality during follow-up.
Results: Among 32 patients, 21 had IE associated with prostheses. Of the latter, 8 had an ascending aorta prosthetic graft. In 24 patients, a switch to long-term oral suppressive antibiotic treatment (LOSAT) was considered. The median duration of LOSAT was 277 days. Four patients experienced a relapse during follow-up. One patient died within 60 days, and 12 patients died between 60 days and 3 years. However, only 4 deaths were related to IE.
Conclusions: The present study results suggest that a LTAT strategy, including LOSAT, might be considered for patients with IE that cannot undergo an indicated surgery. After hospitalization, they should be followed by a multidisciplinary endocarditis team.
Filiaciones:
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Autonomous Univ Barcelona, Dept Med, CIBERCV, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Unitat Malalties Infeccioses, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Escola-Verge, L:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Malalties Infeccioses, Barcelona, Spain
Fernandez-Hidalgo, N:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Malalties Infeccioses, Barcelona, Spain
Ferrer, MG:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Unitat Malalties Infeccioses, Barcelona, Spain
Rodriguez, MTP:
Complexo Hosp Vigo, Unidad Enfermedades Infecciosas, Serv Med Interna, Vigo, Spain
Cuervo, G:
Bellvitge Univ Hosp, Dept Infect Dis, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Internal Med Dept, Barcelona, Spain
Llibre, C:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
:
Hosp Badalona Germans Trias & Pujol, Unitat Malalties Infeccioses, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Microbiol Dept, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Junca, G:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Gual, F:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Sistach, EF:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Vivero, A:
Hosp Badalona Germans Trias & Pujol, Internal Med Dept, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Unitat Malalties Infeccioses, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Neurol Dept, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Pedro-Botet, L:
Autonomous Univ Barcelona, Dept Med, CIBERCV, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Unitat Malalties Infeccioses, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
Autonomous Univ Barcelona, Dept Med, CIBERCV, Barcelona, Spain
Green Published, gold
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