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1. A review of current treatment strategies for infective endocarditis

Author

Ines Lakbar, David Luque Paz, Pierre Tattevin, CHU Pontchaillou [Rennes], CHU Toulouse [Toulouse], ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), This paper was not funded., Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
0301 basic medicine, Microbiology (medical), Oral treatment, medicine.medical_specialty, Prosthesis-Related Infections, Time Factors, empirical treatment, medicine.drug_class, [SDV]Life Sciences [q-bio], 030106 microbiology, Antibiotics, Heart Valve Diseases, review, Microbiology, antibiotics, 03 medical and health sciences, 0302 clinical medicine, enterococci, Virology, medicine, Endocarditis, Animals, Humans, 030212 general & internal medicine, Intensive care medicine, staphylococci, treatment, business.industry, HACEK, oral treatment, Endocarditis, Bacterial, medicine.disease, 3. Good health, Anti-Bacterial Agents, Empirical treatment, Infectious Diseases, streptococci, Infective endocarditis, Heart Valve Prosthesis, Treatment strategy, business
Abstract

International audience; Introduction Infective endocarditis is one of the most difficult-to-treat infectious diseases. Areas covered We restricted this review to the anti-infective treatment of the main bacteria responsible for infective endocarditis, i.e. staphylococci, streptococci, enterococci, and Gram-negative bacilli, including HACEK. Specific topics of major interest in treatment strategy are covered as well, including empirical treatment, oral switch, and treatment duration. We searched in the MEDLINE database to identify relevant studies, trials, reviews, or meta-analyses until May 2020. Expert opinion The use of aminoglycosides for the treatment of endocarditis has been dramatically reduced over the last 20 years. It should be administered once daily, and no longer than 2 weeks. For staphylococcal endocarditis, recent data reinforced the role of anti-staphylococcal penicillins, for methicillin-susceptible isolates (alternative, cefazolin), and vancomycin for methicillin-resistant isolates (alternative, daptomycin). For staphylococcal prosthetic-valve endocarditis, these treatments will be reinforced by the addition of gentamicin during the first 2 weeks, and rifampin throughout the whole treatment duration, i.e. 6 weeks. The optimal duration of antibacterial treatment is 4 weeks for most native valve endocarditis, and 6 weeks for prosthetic-valve endocarditis. The oral switch is safe in patients stabilized after the initial intravenous course.

Published
2021
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2. Prospective Cohort Study of Infective Endocarditis in People Who Inject Drugs

Author

David R. Murdoch, Nuria Fernández-Hidalgo, Eugene Athan, Juan M. Pericàs, José M. Miró, Tomáš Freiberger, Pierre Tattevin, Emanuele Durante-Mangoni, Francisco Nacinovich, Marta Hernández-Meneses, Vivian H. Chu, Zeina A. Kanafani, Jacob Strahilevitz, Jaume Llopis, Cristiane da Cruz Lamas, Margaret M. Hannan, University of Barcelona, Deakin University [Burwood], University of Otago [Dunedin, Nouvelle-Zélande], American University of Beirut [Beyrouth] (AUB), Masaryk University [Brno] (MUNI), Hadassah Hebrew University Medical Center [Jerusalem], Universitat Autònoma de Barcelona (UAB), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Duke University [Durham], This study was supported by the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (# E26/202.782/2015 to Dr. Lamas), Red Española de Investigación en Patología Infecciosa (V-2003-REDC14A-O), and Fondo de Investigaciones Sanitarias de la Seguridad Social (FIS 00-0475) (Dr. Miro). Dr. Miro has received a personal 80:20 research grant from the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, for 2017 to 2021. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., Pericas, J. M., Llopis, J., Athan, E., Hernandez-Meneses, M., Hannan, M. M., Murdoch, D. R., Kanafani, Z., Freiberger, T., Strahilevitz, J., Fernandez-Hidalgo, N., Lamas, C., Durante-Mangoni, E., Tattevin, P., Nacinovich, F., Chu, V. H., Miro, J. M., and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Adult, Male, medicine.medical_specialty, Staphylococcus aureus, cardiac surgery, [SDV]Life Sciences [q-bio], infective endocarditi, Human immunodeficiency virus (HIV), 030204 cardiovascular system & hematology, Logistic regression, medicine.disease_cause, Global Health, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Substance Abuse, Intravenous, Aged, Prosthetic valve, people who inject drug, Endocarditis, business.industry, Public health, Incidence, HIV, Middle Aged, medicine.disease, 3. Good health, Cardiac surgery, people who inject drugs, Infective endocarditis, opioid crisis, Female, infective endocarditis, opioid crisi, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

International audience; Background - Infective endocarditis (IE) in people who inject drugs (PWID) is an emergent public health problem. Objectives - The purpose of this study was to investigate IE in PWID and compare it with IE in non-PWID patients. Methods - Two prospective cohort studies (ICE-PCS and ICE-Plus databases, encompassing 8,112 IE episodes from 2000 to 2006 and 2008 to 2012, with 64 and 34 sites and 28 and 18 countries, respectively). Outcomes were compared between PWID and non-PWID patients with IE. Logistic regression analyses were performed to investigate risk factors for 6-month mortality and relapses amongst PWID. Results - A total of 7,616 patients (591 PWID and 7,025 non-PWID) were included. PWID patients were significantly younger (median 37.0 years [interquartile range: 29.5 to 44.2 years] vs. 63.3 years [interquartile range: 49.3 to 74.0 years]; p

Published
2021
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