Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis
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 s...
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Veröffentlicht in: | Cardiology journal 2021, Vol.28 (4), p.566-578 |
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creator | Vallejo Camazon, Nuria Mateu, Lourdes Cediel, Germán Escolà-Vergé, Laura Fernández-Hidalgo, Nuria Gurgui Ferrer, Mercedes Perez Rodriguez, Maria Teresa Cuervo, Guillermo Nuñez Aragón, Raquel Llibre, Cinta Sopena, Nieves Quesada, Maria Dolores Berastegui, Elisabeth Teis, Albert Lopez Ayerbe, Jorge Juncà, Gladys Gual, Francisco Ferrer Sistach, Elena Vivero, Ainhoa Reynaga, Esteban Hernández Pérez, Maria Muñoz Guijosa, Christian Pedro-Botet, Lluisa Bayés-Genís, Antoni |
description | 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. |
doi_str_mv | 10.5603/CJ.a2021.0054 |
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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.</description><identifier>ISSN: 1897-5593</identifier><identifier>EISSN: 1898-018X</identifier><identifier>DOI: 10.5603/CJ.a2021.0054</identifier><identifier>PMID: 34031866</identifier><language>eng</language><publisher>Gdansk: Wydawnictwo Via Medica</publisher><subject>Antibiotics ; Clinical Cardiology ; Endocarditis ; Patients ; Surgery</subject><ispartof>Cardiology journal, 2021, Vol.28 (4), p.566-578</ispartof><rights>2021. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2021 Via Medica 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-fc1eb0a4b8048f246b42f5987460e9f7273f1147e5794562f59a38d5e39a45a63</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276997/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276997/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,864,885,4024,27923,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Vallejo Camazon, Nuria</creatorcontrib><creatorcontrib>Mateu, Lourdes</creatorcontrib><creatorcontrib>Cediel, Germán</creatorcontrib><creatorcontrib>Escolà-Vergé, Laura</creatorcontrib><creatorcontrib>Fernández-Hidalgo, Nuria</creatorcontrib><creatorcontrib>Gurgui Ferrer, Mercedes</creatorcontrib><creatorcontrib>Perez Rodriguez, Maria Teresa</creatorcontrib><creatorcontrib>Cuervo, Guillermo</creatorcontrib><creatorcontrib>Nuñez Aragón, Raquel</creatorcontrib><creatorcontrib>Llibre, Cinta</creatorcontrib><creatorcontrib>Sopena, Nieves</creatorcontrib><creatorcontrib>Quesada, Maria Dolores</creatorcontrib><creatorcontrib>Berastegui, Elisabeth</creatorcontrib><creatorcontrib>Teis, Albert</creatorcontrib><creatorcontrib>Lopez Ayerbe, Jorge</creatorcontrib><creatorcontrib>Juncà, Gladys</creatorcontrib><creatorcontrib>Gual, Francisco</creatorcontrib><creatorcontrib>Ferrer Sistach, Elena</creatorcontrib><creatorcontrib>Vivero, Ainhoa</creatorcontrib><creatorcontrib>Reynaga, Esteban</creatorcontrib><creatorcontrib>Hernández Pérez, Maria</creatorcontrib><creatorcontrib>Muñoz Guijosa, Christian</creatorcontrib><creatorcontrib>Pedro-Botet, Lluisa</creatorcontrib><creatorcontrib>Bayés-Genís, Antoni</creatorcontrib><title>Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis</title><title>Cardiology journal</title><description>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.</description><subject>Antibiotics</subject><subject>Clinical Cardiology</subject><subject>Endocarditis</subject><subject>Patients</subject><subject>Surgery</subject><issn>1897-5593</issn><issn>1898-018X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkc1r3DAQxUVpadKkx94FufTirb4tXQphSdqGhV5ayE3I8tirsJY2kpyy_328-Si0pxmY37yZx0PoEyUrqQj_sr5ZOUYYXREixRt0SrXRDaH69u1T3zZSGn6CPpRyR4gyUrL36IQLwqlW6hRNmxTHpkKesIs1dCHV4HHdQnb7Aw4R710NEGvBf0Ld4jLnEfKhCbEP3lXocUwVz7GHPKYQx1dg2RzA1_AAGGKfvMt9qKGco3eD2xX4-FLP0O_rq1_r783m57cf68tN47lhtRk8hY440Wki9MCE6gQbpNGtUATM0LKWD5SKFmRrhFTHmeO6l8CNE9Ipfoa-Puvu526C3i8GstvZfQ6TywebXLD_TmLY2jE9WM1aZUy7CHx-EcjpfoZS7RSKh93ORUhzsUxyxpbTUi7oxX_oXZpzXOxZpogQWlKtF6p5pnxOpWQY_j5DiT0Gadc39ilIewySPwIlz5F4</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Vallejo Camazon, Nuria</creator><creator>Mateu, Lourdes</creator><creator>Cediel, Germán</creator><creator>Escolà-Vergé, Laura</creator><creator>Fernández-Hidalgo, Nuria</creator><creator>Gurgui Ferrer, Mercedes</creator><creator>Perez Rodriguez, Maria Teresa</creator><creator>Cuervo, Guillermo</creator><creator>Nuñez Aragón, Raquel</creator><creator>Llibre, Cinta</creator><creator>Sopena, Nieves</creator><creator>Quesada, Maria Dolores</creator><creator>Berastegui, Elisabeth</creator><creator>Teis, Albert</creator><creator>Lopez Ayerbe, Jorge</creator><creator>Juncà, Gladys</creator><creator>Gual, Francisco</creator><creator>Ferrer Sistach, Elena</creator><creator>Vivero, Ainhoa</creator><creator>Reynaga, Esteban</creator><creator>Hernández Pérez, Maria</creator><creator>Muñoz Guijosa, Christian</creator><creator>Pedro-Botet, Lluisa</creator><creator>Bayés-Genís, Antoni</creator><general>Wydawnictwo Via Medica</general><general>Via Medica</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2021</creationdate><title>Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis</title><author>Vallejo Camazon, Nuria ; 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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.</abstract><cop>Gdansk</cop><pub>Wydawnictwo Via Medica</pub><pmid>34031866</pmid><doi>10.5603/CJ.a2021.0054</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Antibiotics Clinical Cardiology Endocarditis Patients Surgery |
title | Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis |
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