Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

被引:21
作者
Vallejo Camazon, Nuria [1 ,2 ]
Mateu, Lourdes [3 ]
Cediel, German [1 ]
Escola-Verge, Laura [4 ]
Fernandez-Hidalgo, Nuria [4 ]
Gurgui Ferrer, Mercedes [5 ]
Perez Rodriguez, Maria Teresa [6 ]
Cuervo, Guillermo [7 ]
Nunez Aragon, Raquel [8 ]
Llibre, Cinta [1 ]
Sopena, Nieves [3 ]
Dolores Quesada, Maria [9 ]
Berastegui, Elisabeth [1 ]
Teis, Albert [1 ]
Lopez Ayerbe, Jorge [1 ]
Junca, Gladys [1 ]
Gual, Francisco [1 ]
Ferrer Sistach, Elena [1 ]
Vivero, Ainhoa [8 ]
Reynaga, Esteban [3 ]
Hernandez Perez, Maria [10 ]
Munoz Guijosa, Christian [1 ]
Pedro-Botet, Lluisa [2 ,3 ]
Bayes-Genis, Antoni [1 ,2 ]
机构
[1] Hosp Badalona Germans Trias & Pujol, Heart Inst, Carretera Canyet S-N, Barcelona 08916, Spain
[2] Autonomous Univ Barcelona, Dept Med, CIBERCV, Barcelona, Spain
[3] Hosp Badalona Germans Trias & Pujol, Unitat Malalties Infeccioses, Barcelona, Spain
[4] Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Malalties Infeccioses, Barcelona, Spain
[5] Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Unitat Malalties Infeccioses, Barcelona, Spain
[6] Complexo Hosp Vigo, Unidad Enfermedades Infecciosas, Serv Med Interna, Vigo, Spain
[7] Bellvitge Univ Hosp, Dept Infect Dis, Barcelona, Spain
[8] Hosp Badalona Germans Trias & Pujol, Internal Med Dept, Barcelona, Spain
[9] Hosp Badalona Germans Trias & Pujol, Microbiol Dept, Barcelona, Spain
[10] Hosp Badalona Germans Trias & Pujol, Neurol Dept, Barcelona, Spain
关键词
suppressive antibiotic treatment; infective endocarditis; surgery; ANTIMICROBIAL THERAPY; CLINICAL PRESENTATION; SUPPRESSIVE THERAPY; PROSTHETIC GRAFT; OPERATIVE RISK; MANAGEMENT; DIAGNOSIS; CHALLENGES; MORTALITY; ETIOLOGY;
D O I
10.5603/CJ.a2021.0054
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:566 / 578
页数:13
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