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Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study

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.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: PLoS One . 2020 Aug 3;15(8):e0237011

Editorial: Public Library of Science

 Año de publicación: 2020

Nº de páginas: 12

Tipo de publicación: Artículo de Revista

 DOI: 10.1371/journal.pone.0237011

ISSN: 1932-6203

Url de la publicación: https://doi.org/10.1371/journal.pone.0237011

Autores/as

RAMOS MARTÍNEZ, ANTONIO

PERICÀS, JUAN MANUEL

FERNÁNDEZ CRUZ, ANA

MUÑOZ, PATRICIA

VALERIO, MARICELA

KESTLER, MARTHA

SOUSA, DOLORES

DOMÍNGUEZ, FERNANDO

OJEDA BURGOS, GUILLERMO

PLATA, ANTONIO

VIDAL, LAURA

MIRÓ, JOSÉ MARÍA

GRUPO DE APOYO AL MANEJO DE LA ENDOCARDITIS INFECCIOSA EN ESPAÑA (GAMES)