RT Journal Article
T1 Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study.
A1 Ramos-Martinez, Antonio
A1 Pericas, Juan Manuel
A1 Fernandez-Cruz, Ana
A1 Muñoz, Patricia
A1 Valerio, Maricela
A1 Kestler, Martha
A1 Montejo, Miguel
A1 Fariñas, M Carmen
A1 Sousa, Dolores
A1 Dominguez, Fernando
A1 Ojeda-Burgos, Guillermo
A1 Plata, Antonio
A1 Vidal, Laura
A1 Miro, Jose Maria
K1 Drug Therapy, Combination
K1 Endocarditis
K1 Endocarditis, Bacterial
K1 Enterococcus faecalis
AB 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.
PB Public Library of Science
YR 2020
FD 2020-08-03
LK http://hdl.handle.net/10668/16038
UL http://hdl.handle.net/10668/16038
LA en
NO Ramos-Martínez A, Pericàs JM, Fernández-Cruz A, Muñoz P, Valerio M, Kestler M, et al. Four weeks versus six weeks of ampicillin plus ceftriaxone in Enterococcus faecalis native valve endocarditis: A prospective cohort study. PLoS One. 2020 Aug 3;15(8):e0237011
DS RISalud
RD Apr 9, 2025