Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study

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...

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Autores: Ramos Martínez, Antonio, Pericàs, Juan M., Fernández Cruz, Ana, Muñoz, Patricia, Valerio, Maricela, Kestler, Martha, Montejo, Miguel, Fariñas, M. Carmen, Sousa, Dolores, Domínguez, Fernando, Ojeda Burgos, Guillermo, Plata, Antonio, Vidal, Laura, Miró Meda, José M. (José María), 1956-, Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España(GAMES)
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/176808
Acceso en línea:https://hdl.handle.net/2445/176808
Access Level:acceso abierto
Palabra clave:Endocarditis
Vàlvules
Mortalitat
Valves
Mortality
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spelling Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort studyRamos Martínez, AntonioPericàs, Juan M.Fernández Cruz, AnaMuñoz, PatriciaValerio, MaricelaKestler, MarthaMontejo, MiguelFariñas, M. CarmenSousa, DoloresDomínguez, FernandoOjeda Burgos, GuillermoPlata, AntonioVidal, LauraMiró Meda, José M. (José María), 1956-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España(GAMES)EndocarditisVàlvulesMortalitatEndocarditisValvesMortalityEnterococcus 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.Public Library of Science (PLoS)2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/176808Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0237011PLoS One, 2020, vol. 15, num. 8, p. e0237011https://doi.org/10.1371/journal.pone.0237011cc-by (c) Ramos Martínez, Antonio et al., 2020http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1768082026-05-27T06:46:51Z
dc.title.none.fl_str_mv Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
title Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
spellingShingle Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
Ramos Martínez, Antonio
Endocarditis
Vàlvules
Mortalitat
Endocarditis
Valves
Mortality
title_short Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
title_full Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
title_fullStr Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
title_full_unstemmed Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
title_sort Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study
dc.creator.none.fl_str_mv Ramos Martínez, Antonio
Pericàs, Juan M.
Fernández Cruz, Ana
Muñoz, Patricia
Valerio, Maricela
Kestler, Martha
Montejo, Miguel
Fariñas, M. Carmen
Sousa, Dolores
Domínguez, Fernando
Ojeda Burgos, Guillermo
Plata, Antonio
Vidal, Laura
Miró Meda, José M. (José María), 1956-
Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España(GAMES)
author Ramos Martínez, Antonio
author_facet Ramos Martínez, Antonio
Pericàs, Juan M.
Fernández Cruz, Ana
Muñoz, Patricia
Valerio, Maricela
Kestler, Martha
Montejo, Miguel
Fariñas, M. Carmen
Sousa, Dolores
Domínguez, Fernando
Ojeda Burgos, Guillermo
Plata, Antonio
Vidal, Laura
Miró Meda, José M. (José María), 1956-
Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España(GAMES)
author_role author
author2 Pericàs, Juan M.
Fernández Cruz, Ana
Muñoz, Patricia
Valerio, Maricela
Kestler, Martha
Montejo, Miguel
Fariñas, M. Carmen
Sousa, Dolores
Domínguez, Fernando
Ojeda Burgos, Guillermo
Plata, Antonio
Vidal, Laura
Miró Meda, José M. (José María), 1956-
Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España(GAMES)
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Endocarditis
Vàlvules
Mortalitat
Endocarditis
Valves
Mortality
topic Endocarditis
Vàlvules
Mortalitat
Endocarditis
Valves
Mortality
description 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.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/176808
url https://hdl.handle.net/2445/176808
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0237011
PLoS One, 2020, vol. 15, num. 8, p. e0237011
https://doi.org/10.1371/journal.pone.0237011
dc.rights.none.fl_str_mv cc-by (c) Ramos Martínez, Antonio et al., 2020
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Ramos Martínez, Antonio et al., 2020
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300719

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