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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Short report: impact of selective reporting of antibiotic susceptibility testing on antibiotic use in patients with bloodstream infection with Enterococcus faecalis.
Florian Geismann,Stefan Handschuh,Maximilian V. Malfertheiner,Bernd Salzberger,Stilla Bauernfeind,Florian Hitzenbichler,Michael Simon,Aila Luise Caplunik-Pratsch,Wulf Schneider-Brachert,C Wiest,Tamara Ruegamer,Arno Wilhelm Mohr +11 more
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Infekční endokarditida v roce 2018
TL;DR: HemokultivaAnĂ a echokardiografickĂS vyĹĄetĹ�’enĂs jsou zĂĄkladn—mi kameny diagnostiky IE, yn â‹Żkazech zĹžpolovina pacientĹ Ż je v akutnĄzi onemocn
Journal ArticleDOI
A retrospective study of Enterococcus faecalis infective endocarditis: comparison of clinical characteristics and outcomes associated with treatment
TL;DR: Combination treatment of EFIE with AC is associated with a reduced number of adverse events in comparison to AG groups, and although increased mortality was observed in the AC group, this did not reach statistical significance, and reflects the greater comorbidities and reduced capacity for surgical source control in this cohort.
Controlled Release of Amplcillin from Nanorervoirs of Sol-gel Silica and Titania
Abstract: In this study, sol-gel processes were used in order to synthesize TiO2 microtubes and SiO2-SBA-15. Ampicillin was incorporated into these materials. In order to confirm the rate of release, low amounts of antibiotic was added over an infected area for different periods of time. Our results show that all nanomaterials obtained, are mesoporous and present luminescent effects when ampicillin is added. The release of ampicillin from the different nanoparticulate reservoirs was tested up to 800 h. Following a 3 hour period, equilibrium was reached and controlled release started begin faster for the SBA-15. The release curves showed that the equilibrium reaching order was SBA-15 > monoliths > titania microtubes. At this point the release occurred in a controlled manner until the antibiotic was over. These results provide great benefits, because many infections can be treated using small doses of ampicillin. In addition to this, it prevents bacteria and virus from BECOMING resistant. *Corresponding author: Tessy Lopez, Universidad Autónoma Metropolitana-Xochimilco, Nanomedicine Laboratory, Calzada del Hueso 1100, Villa Quietud, Coyoacán, 04960, Ciudad de Mexico, Mexico. E-mail: tessy3@prodigy.net.mx Received June 7, 2017; Accepted July 12, 2017; Published July 25, 2017 Citation: Tessy Lopez (2017) Controlled Release of Amplcillin from Nanorervoirs of Sol-gel Silica and Titania. SF Nano Res Let 1:2. Copyright: © 2017 Tessy Lopez. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Journal ArticleDOI
Rigor in the Design of Observational Noninferiority Trials
TL;DR: An important observational active-comparator study to address the need for an aminoglycoside antibiotic in the treatment of enterococcal endocarditis is reported, but the failure to appropriately test a noninferiority (or equivalence) hypothesis erodes confidence in the conclusion.
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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
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.
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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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Journal ArticleDOI
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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