Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/176808
Title: Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
Author: Ramos Martínez, Antonio
Pericàs, Juan Manuel
Fernández Cruz, Ana
Muñoz, Patricia
Valerio, Maricela
Kestler, Martha
Montejo, Miguel
Fariñas, M. Carmen
Sousa, Dolores
Domínguez, Fernando
Ojeda Burgos, Guillermo
Plata, Antonio
Vidal, Laura
Miró Meda, José M.
Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España(GAMES)
Keywords: Endocarditis
Vàlvules
Mortalitat
Endocarditis
Valves
Mortality
Issue Date: 3-Aug-2020
Publisher: Public Library of Science (PLoS)
Abstract: Enterococcus faecalis infective 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.
Note: Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0237011
It is part of: PLoS One, 2020, vol. 15, num. 8, p. e0237011
URI: http://hdl.handle.net/2445/176808
Related resource: https://doi.org/10.1371/journal.pone.0237011
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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