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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.
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
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RAMOS MARTÍNEZ, ANTONIO
PERICÀS, JUAN MANUEL
FERNÁNDEZ CRUZ, ANA
MUÑOZ, PATRICIA
VALERIO, MARICELA
KESTLER, MARTHA
MONTEJO, MIGUEL
MARIA DEL CARMEN FARIÑAS ALVAREZ
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)
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