Streptococcal and enterococcal endocarditis: time for individualized antibiotherapy?

被引：8

作者：

Flateau, Clara ^{[1
]}

Riazi, Adelie ^{[2
]}

Cassard, Bruno ^{[2
]}

Camus, Maryse ^{[2
]}

Diamantis, Sylvain ^{[1
]}

机构：

[1] Grp Hosp Sud Ile France GHSIF, Dept Trop & Infect Dis, Melun, France

[2] Hosp Pharm, Grp Hosp Sud Ile France GHSIF, Melun, France

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2021年 / 76卷 / 12期

关键词：

AMPICILLIN PLUS CEFTRIAXONE; CARDIAC VEGETATIONS; INFECTIVE ENDOCARDITIS; PENICILLIN RESISTANCE; FIBRIN CLOTS; AMOXICILLIN; FAECALIS; GENTAMICIN; PHARMACOKINETICS; ABSORPTION;

D O I：

10.1093/jac/dkab333

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Recommendations for the treatment of streptococcal and enterococcal endocarditis are based on old efficacy studies, but the starting doses have never been reassessed and are associated with significant adverse events. Based on data from other serious infections, we suggest that maintaining a concentration of beta-lactams higher than 4-6 times the responsible bacteria MIC 100% of the time in the heart of the vegetation would be a pertinent therapeutic objective. The data point to a diffusion gradient of beta-lactams in the vegetation. Yet, so far as is known, the ratio of antibiotic concentration at steady state between plasma and vegetation cannot be completely determined. Answering this crucial question would make it possible for each patient to have a targeted beta-lactam plasma concentration, according to the MIC for the responsible bacteria. This would lead the way to personalized antibiotherapy and allow a safe switch to oral medication.

引用

页码：3073 / 3076

页数：4

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