In Vitro Activity of Ampicillin Plus Ceftriaxone Against Non-faecalis and Non-faecium Enterococcal Isolates With/Without VanC Phenotype: Clinical Implications for Infective Endocarditis. 

1) Background: Alternative antibiotics are needed to treat infective endocarditis (IE) caused by non-faecalis/non-faecium enterococci; we aimed to assess the in vitro activity of ampicillin plus ceftriaxone (AMP + CTR) against these enterococci and to describe its clinical efficacy in IE cases. (2)...

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Detalles Bibliográficos
Autores: García González, Javier, Cañas, María Alexandra, Cuervo Requena, Guillermo, Hernández Meneses, Marta, Verdejo, Miguel Ángel, Bodro, Marta, Díez de los Ríos, Javier, Gasch, Oriol, Ribera, Alba, Falces Salvador, Carles, Perissinotti, Andrés, Vidal, Bàrbara, Quintana, Eduard, Moreno Camacho, Ma. Asunción, Piquet, Maria, Roca Subirà, Ignasi, Fernández Pittol, Mariana José, San José Villar, Sol María, García de la Mària, Cristina, Miró Meda, José M. (José María), 1956-, Hospital Clínic Endocarditis Study Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/228158
Acceso en línea:https://hdl.handle.net/2445/228158
Access Level:acceso abierto
Palabra clave:Endocarditis
Enterobacteriàcies
Infeccions
Enterobacteriaceae
Infections
Descripción
Sumario:1) Background: Alternative antibiotics are needed to treat infective endocarditis (IE) caused by non-faecalis/non-faecium enterococci; we aimed to assess the in vitro activity of ampicillin plus ceftriaxone (AMP + CTR) against these enterococci and to describe its clinical efficacy in IE cases. (2) Methods: Time–kill curves with standard (ISI) and high (IHI) inocula were performed to test VanC isolates [3 E. casseliflavus (ECAS) and 1 E. gallinarum (EGALL)] and non-VanC isolates [1 E. durans (EDUR), 1 E. hirae (EHIR) and 1 E. raffinosus (ERAF)]. The narrative literature review of IE cases treated with AMP + CTR was analyzed alongside three study cases. Clinical outcomes were relapse and death. (3) Results: Ampicillin plus gentamicin (AMP + GEN) showed synergistic and bactericidal activity against most isolates. AMP + CTR was synergistic at ISI for EGALL, EDUR, and EHIR and bactericidal against EHIR. At IHI, indifferent activity was observed for all isolates. In IE cases treated with AMP + CTR, it was only effective for EDUR and EHIR. Clinical information for EGALL IE is lacking. For IE caused by ECAS and ERAF, AMP + CTR seems suboptimal or ineffective, respectively. (4) AMP + CTR cannot be recommended for treating IE due to ECAS/ERAF. In contrast, this combination was effective in IE caused by EDUR/EHIR and could be recommended.

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