1. Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis
- Author
-
Vallejo Camazon, Nuria, Mateu, Lourdes, Cediel, Germán, Escolà-Vergé, Laura, Fernández-Hidalgo, Nuria, Gurguí, Mercè, Pérez Rodriguez, María Teresa, Cuervo, Guillermo, Núñez Aragón, Raquel, Llibre, Cinta, Sopena, Nieves, Quesada, María Dolores, Berastegui García, Elisabet, Teis, Albert, López Ayerbe, Jorge, Juncà Puig, Gladys, Gual, Francisoc, Ferrer Sistach, Elena, Vivero, Ainhoa, Reynaga, Esteban, Hernández Pérez, María, Muñoz Guijosa, Christian, Pedro-Botet, Lluïsa, Bayés-Genís, Antoni, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Vallejo Camazon N] Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain. [Mateu L] Unitat Malalties Infeccioses, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Cediel G] Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Escolà-Vergé L, Fernández-Hidalgo N] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Gurgui Ferrer M] Unitat de Malalties Infeccioses, Hospital Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Male ,medicine.medical_specialty ,Referral ,medicine.drug_class ,Antibiotics ,Bacterial Infections and Mycoses::Bacterial Infections::Endocarditis, Bacterial [DISEASES] ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,Antibiòtics ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos [COMPUESTOS QUÍMICOS Y DROGAS] ,Clinical Cardiology ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,infecciones bacterianas y micosis::infecciones bacterianas::endocarditis bacteriana [ENFERMEDADES] ,surgery ,Antibiotic therapy ,medicine.artery ,Ascending aorta ,medicine ,Medicaments antibacterians - Ús terapèutic ,Humans ,Endocarditis ,In patient ,Other subheadings::/therapeutic use [Other subheadings] ,Aged ,Retrospective Studies ,Cirurgia ,Otros calificadores::/uso terapéutico [Otros calificadores] ,business.industry ,infective endocarditis ,Endocarditis, Bacterial ,General Medicine ,Prognosis ,medicine.disease ,Anti-Bacterial Agents ,Surgery ,Multicenter study ,Infective endocarditis ,suppressive antibiotic treatment ,Endocarditis bacteriana - Tractament ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [CHEMICALS AND DRUGS] ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Edocarditis infecciosa; Tractament antibiòtic supressiu; Cirurgia Endocarditis infecciosa; Tratamiento antibiótico supresor: Cirugía Infective endocarditis; Suppressive antibiotic treatment; Surgery 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. Antoni Bayes-Genis was supported by grants from the Ministerio de Educación y Ciencia (SAF2014–59892), Fundació La MARATÓ de TV3 (201502, 201516), CIBER Cardiovascular (CB16/11/00403), and AdvanceCat 2014. María Hernández Pérez is supported by a Juan Rodes research contract (JR17/00006) from Instituto de Salud Carlos III.
- Published
- 2021