Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11559
Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
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ISSN: 1932-6203
WOS ID: 000560006800054
Scopus EID: 2-s2.0-85089040573
PMID: 32745091
Embase PUI: L2007386698
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Ramos-Martinez, Antonio; Pericas, Juan Manuel; Fernandez-Cruz, Ana; Munoz, Patricia; Valerio, Maricela; Kestler, Martha; Montejo, Miguel; Farinas, M. Carmen; Sousa, Dolores; Dominguez, Fernando; Ojeda-Burgos, Guillermo; Plata, Antonio; Vidal, Laura; Miro, Jose Maria; Grp Apoyo Manejo EndocarditisPublication date
2020-08-03Document type
research articleCitation
Ramos-Martinez A, Pericas JM, Fernandez-Cruz A, Muñoz P, Valerio M, Kestler M, et al. Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study. PLoS One. 2020 Aug 03;15(8):e0237011.Abstract
Enterococcus faecalisinfective endocarditis (EFIE) is a severe disease of increasing incidence. The objective was to analyze whether the outcome of patients with native valve EFIE (NVEFIE) treated with a short course of ampicillin plus ceftriaxone (4wAC) was similar to patients treated according to international guidelines (6wAC). Between January 2008 and June 2018, 1,978 consecutive patients with definite native valve IE were prospectively included in a national registry. Outcomes of patients with NVEFIE treated with 4wAC were compared to those of patients who received 6wAC. Three hundred and twenty-two patients (16.3%) had NVEFIE. One hundred and eighty-three (56.8%) received AC. Thirty-nine patients (21.3%) were treated with 4wAC for four weeks and 70 patients (38.3%) with 6wAC. There were no differences in age or comorbidity. Patients treated 6wAC presented a longer duration of symptoms before diagnosis (21 days, IQR 7-60 days vs. 7 days, IQR 1-22 days; p = 0.002). Six patients presented perivalvular abscess and all of these received 6wAC. Surgery was performed on 14 patients (35.9%) 4wAC and 34 patients (48.6%) 6wAC (p = 0.201). In-hospital mortality, one-year mortality and relapses among 4wAC and 6wAC patients were 10.3% vs. 11.4% (p = 0.851); 17.9% vs. 21.4% (p = 0.682) and 5.1% vs. 4.3% (p = 0.833), respectively. In conclusion, a four-week course of AC may be considered as an alternative regimen in NVEFIE, notably in patients with shorter duration of symptoms and those without perivalvular abscess. These results support the performance of a randomized clinical trial to evaluate the efficacy of this short regimen.
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https://dx.doi.org/10.1371/journal.pone.0237011MeSH
AmpicillinGentamicins
Aged, 80 and over
Aged
Enterococcus faecalis
Anti-Bacterial Agents
Ceftriaxone
Endocarditis, Bacterial
Humans
Drug Therapy, Combination
Gram-Positive Bacterial Infections
Endocarditis
Male
Prospective Studies
Time Factors
Female
Cohort Studies
DeCS
Estudios de CohortesFactores de Tiempo
Femenino
Infecciones por Bacterias Grampositivas
Masculino
Endocarditis
Endocarditis Bacteriana
Quimioterapia Combinada
Ceftriaxona
Humanos
Estudios Prospectivos
Anciano
Anciano de 80 o más Años
Ampicilina
Antibacterianos
Enterococcus faecalis
Gentamicinas