Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis
Vallejo Camazon, Nuria (Universitat Autònoma de Barcelona. Departament de Medicina)
Mateu, Lourdes (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Escolà-Vergé, Laura (Hospital Universitari Vall d'Hebron)
Fernández-Hidalgo, Nuria (Hospital Universitari Vall d'Hebron)
Gurguí, Mercè (Institut d'Investigació Biomèdica Sant Pau)
Pérez Rodriguez, María Teresa (Unidad de Enfermedades Infecciosas. Servicio de Medicina Interna. Complexo Hospitalario de Vigo)
Cuervo, Guillermo (Hospital Universitari de Bellvitge)
Núñez Aragón, Raquel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Llibre, Cinta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sopena, Nieves (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Quesada, María Dolores (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Berastegui García, Elisabet (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Teis, Albert (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
López Ayerbe, Jorge (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Juncà Puig, Gladys (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gual, Francisoc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer Sistach, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vivero, Ainhoa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Reynaga, Esteban (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Hernández Pérez, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Muñoz Guijosa, Christian (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pedro-Botet, Lluïsa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	Background: To date, there is little information regarding management of patients with infective endocarditis (IE) that did not undergo an indicated surgery. Therefore, we aimed to evaluate prognosis of these patients treated with a long-term antibiotic treatment strategy, including oral long term suppressive antibiotic treatment in five referral centres with a multidisciplinary endocarditis team. Methods: This retrospective, multicenter study retrieved individual patient-level data from five referral centres in Spain. Among a total of 1797, 32 consecutive patients with IE were examined (median age 72 years; 78% males) who had not undergone an indicated surgery, but received long-term antibiotic treatment (LTAT) and were followed by a multidisciplinary endocarditis team, between 2011 and 2019. Primary outcomes were infection relapse and mortality during follow-up. Results: Among 32 patients, 21 had IE associated with prostheses. Of the latter, 8 had an ascending aorta prosthetic graft. In 24 patients, a switch to long-term oral suppressive antibiotic treatment (LOSAT) was considered. The median duration of LOSAT was 277 days. Four patients experienced a relapse during follow-up. One patient died within 60 days, and 12 patients died between 60 days and 3 years. However, only 4 deaths were related to IE. Conclusions: The present study results suggest that a LTAT strategy, including LOSAT, might be considered for patients with IE that cannot undergo an indicated surgery. After hospitalization, they should be followed by a multidisciplinary endocarditis team.
Ayudas:	Ministerio de Economía y Competitividad SAF2014-59892 Instituto de Salud Carlos III CB16/11/00403 Instituto de Salud Carlos III JR17/00006
Nota:	Altres ajuts: Fundació La MARATÓ de TV3 (201502, 201516); CIBER Cardiovascular; AdvanceCat 2014.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Suppressive antibiotic treatment ; Infective endocarditis ; Surgery
Publicado en:	Cardiology Journal, Vol. 28 Núm. 4 (2021) , p. 566-578, ISSN 1898-018X

DOI: 10.5603/CJ.a2021.0054
PMID: 34031866

13 p, 254.3 KB

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