Ampicillin Plus Ceftriaxone Is as Effective as Ampicillin Plus Gentamicin for Treating Enterococcus faecalis Infective Endocarditis
Nuria Fernández-Hidalgo,Benito Almirante,Joan Gavaldà,Mercè Gurguí,Carmen Peña,Arístides de Alarcón,Josefa Ruiz,Isidre Vilacosta,Miguel Montejo,Nuria Vallejo,Francisco López-Medrano,Antonio Plata,Javier E. López,Carmen Hidalgo-Tenorio,J. Gálvez,Carmen Sáez,José Manuel Lomas,Marco Falcone,Javier de la Torre,Xavier Martínez-Lacasa,Albert Pahissa +20 more
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AC appears as effective as AG for treating EFIE patients and can be used with virtually no risk of renal failure and regardless of the high-level aminoglycoside resistance status of E. faecalis.Abstract:
(See the Editorial Commentary by Munita et al on pages 1269–72.) Background. The aim of this study was to compare the effectiveness of the ampicillin plus ceftriaxone (AC) and ampicillin plus gentamicin (AG) combinations for treating Enterococcus faecalis infective endocarditis (EFIE). Methods. An observational, nonrandomized, comparative multicenter cohort study was conducted at 17 Spanish and 1 Italian hospitals. Consecutive adult patients diagnosed of EFIE were included. Outcome measurements were death during treatment and at 3 months of follow-up, adverse events requiring treatment withdrawal, treatment failure requiring a change of antimicrobials, and relapse. Results. A larger percentage of AC-treated patients (n = 159) had previous chronic renal failure than AG-treated patients (n= 87) (33% vs 16%, P=.004), and AC patients had a higher incidence of cancer (18% vs 7%, P= .015), transplantation (6% vs 0%, P= .040), and healthcare-acquired infection (59% vs 40%, P= .006). Between AC and AGtreated EFIE patients, there were no differences in mortality while on antimicrobial treatment (22% vs 21%, P=.81) or at 3-month follow-up (8% vs 7%, P= .72), in treatment failure requiring a change in antimicrobials (1% vs 2%, P= .54), or in relapses (3% vs 4%, P=.67). However, interruption of antibiotic treatment due to adverse events was much more frequent in AG-treated patients than in those receiving AC (25% vs 1%, P< .001), mainly due to new renal failure (≥25% increase in baseline creatinine concentration; 23% vs 0%, P< .001). Conclusions. AC appears as effective as AG for treating EFIE patients and can be used with virtually no risk of renal failure and regardless of the high-level aminoglycoside resistance status of E. faecalis.read more
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Linezolid-resistant staphylococcal bacteraemia: A multicentre case-case-control study in Italy
Alessandro Russo,Floriana Campanile,Marco Falcone,Carlo Tascini,Matteo Bassetti,Paola Goldoni,Maria Trancassini,Paola Della Siega,Francesco Menichetti,Stefania Stefani,Mario Venditti +10 more
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TL;DR: There is promising in vitro data but little clinical evidence supporting combination beta-lactam therapy for this indication, although combination therapy may be useful in refractory cases of bacteremia that do not respond to standard antibiotic therapy.
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How do I manage a patient with enterococcal bacteraemia
TL;DR: Topics are covered: epidemiological, clinical and microbiological characteristics and factors associated to prognosis of EB; diagnosis and work-up including the use of echocardiography to rule out endocarditis; antibiotic management with special focus on antimicrobial resistance and complicated EB; and the role of infectious disease consultation and theUse of bundles in EB.
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Enterococcal endocarditis revisited.
Juan M. Pericàs,Yuliya Zboromyrska,Carlos Cervera,Ximena Castañeda,Manuel Almela,Cristina Garcia-de-la-Maria,C.A. Mestres,Carlos Falces,Eduard Quintana,Salvador Ninot,Jaume Llopis,F. Marco,A. Moreno,Miró Jm +13 more
TL;DR: Ampicillin plus ceftriaxone 2 g iv./12 h is a good option for Enterococcus faecalis IE caused by HLAR strains, but randomized clinical trials are essential to demonstrate its efficacy for non-HLAR EFIE and to compare it with ampicillinplus short-course gentamicin.
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Proposed Modifications to the Duke Criteria for the Diagnosis of Infective Endocarditis
Jennifer S. Li,Daniel J. Sexton,Nathan Mick,Richard E. Nettles,Vance G. Fowler,Thomas J. Ryan,Thomas M. Bashore,G. R. Corey +7 more
TL;DR: Modifications of the Duke criteria for the diagnosis of infective endocarditis are proposed, including that positive Q-fever serology should be changed to a major criterion and the minor criterion "echocardiogram consistent with IE but not meeting major criterion" should be eliminated.
Journal ArticleDOI
Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century: The International Collaboration on Endocarditis-Prospective Cohort Study
David R. Murdoch,G. Ralph Corey,Bruno Hoen,José M. Miró,Vance G. Fowler,Arnold S. Bayer,Adolf W. Karchmer,Lars Olaison,Paul A. Pappas,Philippe Moreillon,Stephen T. Chambers,Vivian H. Chu,Vicenç Falcó,David Holland,Philip Jones,John L Klein,Nigel Raymond,Kerry Read,Marie Francoise Tripodi,Riccardo Utili,Andrew Wang,Christopher W. Woods,Christopher H. Cabell +22 more
TL;DR: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection, and Mortality remains relatively high.
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Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009)
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Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009)
Gilbert Habib,Bruno Hoen,Pilar Tornos,Franck Thuny,Bernard Prendergast,Isidre Vilacosta,Philippe Moreillon,Manuel J. Antunes,Ulf Thilén,John Lekakis,Maria Lengyel,Ludwig Müller,Christoph Naber,Petros Nihoyannopoulos,Anton Moritz,José Luis Zamorano,M. O. Evseev +16 more
TL;DR: Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009).
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