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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TLDR
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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How to manage patients in whom malignancy and infective endocarditis are associated: a review.
TL;DR: The results indicate that cardiac surgery for IE should not be withheld in patients in whom a treatable malignancy has been found, and the short-term outcome of IE is unaltered by cancer.
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Enterococcal Diskitis: Case Reports and Review of Reported Patients
TL;DR: 2 patients diagnosed with enterococcal vertebral spondylodiskitis are described, leading to the unsuspected diagnosis of endocarditis in one, and because of high-level aminoglycoside resistance, one patient received a 6-week course of ampicillin and ceftriaxone.
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Follow guidance to individualize antibacterial regimens when treating infective endocarditis
TL;DR: The management of infective endocarditis requires individualized treatment and a multi-disciplinary team, and guidelines are available to help aid antibacterial decisions, taking into account the causative pathogens and patient factors.
Book ChapterDOI
Miscellaneous Antibacterial Drugs
TL;DR: This review of the January 2012 to June 2013 publications on miscellaneous antibacterial drugs covers aminoglycosides, fluoroquinolones, ketolides, lincosamide clindamycin, macrolides, and more.
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Infective endocarditis presenting as diffuse alveolar hemorrhage: A case report.
Mitsunori Morita,Hiromi Tomioka +1 more
TL;DR: An 80-year-old man was admitted to the hospital because of fever, bloody sputum and exertional dyspnea of 3 days, and a diagnosis of infective endocarditis was made according to the Modified Duke's criteria.
References
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Journal ArticleDOI
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.
Journal ArticleDOI
Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009)
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Journal ArticleDOI
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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