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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Reply to Pericàs et al.
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Wichtige Antibiotikaindikationen und Krankheitsbilder unter ASB-Gesichtspunkten
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Successful treatment of relapsed enterococcal endocarditis with amoxicillin/clavulanate: A case report
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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
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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
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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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