Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Baseline Characteristics | Overall (n = 59) | Treatment | p | ||
---|---|---|---|---|---|
AC12 (n = 32) | AC24 (n = 17) | ACjoined (n = 10) | |||
Age (median (IQR)) | 68 (59–77) | 64 (57–73) | 73 (60–80) | 73 (59–77) | 0.127 |
Male gender | 37 (62.7) | 18 (56.3) | 13 (76.5) | 6 (60.0) | 0.372 |
Charlson score (median (IQR)) | 4 (3–5) | 3 (2–5) | 5 (3.5–5.5) | 5 (3.75–5.5) | 0.07 |
Comorbidities | |||||
Hypertension | 32 (54.2) | 16 (50.0) | 9 (52.9) | 7 (70.0) | 0.537 |
Diabetes mellitus | 17 (28.8) | 11 (34.4) | 3 (17.6) | 3 (30.0) | 0.467 |
Hyperlipidaemia | 20 (33.9) | 9 (28.1) | 7 (41.2) | 4 (40.0) | 0.593 |
Chronic renal failure | 13 (22.0) | 9 (28.1) | 3 (17.6) | 1 (10.0) | 0.422 |
Colorectal disease | 16 (27.1) | 4 (12.5) | 9 (52.9) | 3 (30.0) | 0.010 |
Chronic obstructive pulmonary disease | 8 (13.6) | 6 (18.8) | 2 (11.8) | 0 (0.0) | 0.309 |
Cancer | 9 (15.3) | 5 (15.6) | 4 (23.5) | 0 (0.0) | 0.259 |
Peripheral vascular disease | 9 (15.3) | 2 (6.3) | 4 (23.5) | 3 (30.0) | 0.101 |
Liver disease | 6 (10.2) | 5 (15.6) | 1 (5.9) | 0 (0.0) | 0.284 |
Previous cerebrovascular accident | 5 (8.5) | 2 (6.3) | 2 (11.8) | 1 (10.0) | 0.790 |
Previous IE episode | 3 (5.1) | 0 (0.0) | 2 (11.8) | 1 (10.0) | 0.094 |
Prosthetic valve/Pacemaker carrier (involved or not) * | 22 (37.3) | 9 (28.1) | 7 (41.2) | 6 (60.0) | 0.177 |
Prosthetic valve location (involved or not) | |||||
Prosthetic aortic valve | 20 (33.9) | 7 (21.9) | 7 (41.2) | 6 (60.0) | 0.148 |
Prosthetic mitral valve | 4 (6.8) | 2 (6.3) | 1 (5.9) | 1 (10.0) | 0.925 |
Prosthetic tricuspid valve | 1 (1.7) | 1 (3.1) | 0 (0.0) | 0 (0.0) | 0.601 |
Type of prosthesis (involved or not) * | |||||
Valvular prosthesis | 17 (28.8) | 7 (21.9) | 5 (29.4) | 5 (50.00) | 0.555 |
Pacemaker | 4 (6.8) | 2 (6.3) | 2 (11.8) | 0 (0.0) | |
TAVI | 3 (5.1) | 0 (0.0) | 2 (11.8) | 1 (10.00) |
Endocarditis Characteristics | Overall (n = 59) | Treatment | p | ||
---|---|---|---|---|---|
AC12 (n = 32) | AC24 (n = 17) | ACjoined (n = 10) | |||
Type of endocarditis | 0.515 | ||||
Left-side IE | 53 (89.8) | 29 (90.6) | 16 (94.1) | 8 (80.0) | |
Right-side IE | 2 (3.4) | 1 (3.1) | 0 (0.0) | 1 (10.0) | |
Left and right-side IE | 1 (1.7) | 1 (3.1) | 0 (0.0) | 0 (0.0) | |
Other or unknown | 3 (5.1) | 1 (3.1) | 1 (5.9) | 1 (10.0) | |
Native valve IE | 39 (66.1) | 25 (78.1) | 11 (64.7) | 3 (30.0) | 0.019 |
Early prosthetic valve IE (<1 year) | 7 (11.9) | 2 (6.3) | 1 (5.9) | 4 (40.0) | 0.010 |
Late prosthetic valve IE (>1 year) | 10 (16.9) | 5 (15.6) | 3 (17.6) | 2 (20.0) | 0.946 |
Cardiac device-related IE | 3 (5.1) | 0 (0.0) | 2 (11.8) | 1 (10.0) | 0.151 |
Valve involvement | |||||
Aortic valve | 28 (47.5) | 16 (50.0) | 8 (47.1) | 4 (40.0) | 0.858 |
Mitral valve | 14 (23.7) | 8 (25.0) | 4 (23.5) | 2 (20.0) | 0.948 |
Mitral and aortic valves | 11 (18.6) | 5 (15.6) | 4 (23.5) | 2 (20.0) | 0.790 |
Mitral and tricuspid valves | 1 (1.7) | 1 (3.1) | 0 (0.0) | 0 (0.0) | 0.651 |
IVC and tricuspid valve | 2 (3.4) | 1 (3.1) | 0 (0.0) | 1 (10.0) | 0.380 |
Other or unknown | 3 (5.1) | 1 (3.1) | 1 (5.9) | 1 (10.0) | 0.678 |
Cardiac Surgery | |||||
Cardiac surgery indicated * | 32 (54.2) | 20 (62.5) | 10 (58.8) | 2 (20.0) | 0.049 |
Cardiac surgery performed (% of indicated) | 24 (75.0) | 18 (90.0) | 6 (60.0) | 0 (0.0) | 0.008 |
Clinical outcomes | |||||
Relapses | 6 (10.2) | 0 (0.0) | 5 (29.4) | 1 (10.0) | 0.005 |
Side effects related to AC | 7 (11.9) | 6 (18.8) | 0 (0.0) | 1 (10.0) | 0.152 |
Unplanned readmission | 17 (28.8) | 9 (28.1) | 6 (35.3) | 2 (20.0) | 0.693 |
Readmission unrelated to IE | 8 (13.6) | 5 (15.6) | 2 (11.8) | 2 (20.0) | 0.260 |
Readmission related to IE | 9 (15.3) | 4 (12.5) | 5 (29.4) | 0 (0.0) | |
Final outcome | |||||
Cured | 54 (91.5) | 30 (93.8) | 16 (94.1) | 8 (80.0) | 0.177 |
Death unrelated to IE | 2 (3.4) | 1 (3.1) | 1 (5.9) | 0 (0.0) | |
Death related to IE | 3 (5.1) | 1 (3.1) | 0 (0.0) | 2 (20.0) |
Age | CS # | Type IE | AC Group | Surgery (i/p) * | Commentaries | Outcome (Follow-Up) |
---|---|---|---|---|---|---|
87 | 6 | Early prosthetic aortic valve IE in a patient with a pacemaker | AC24 | No/No | Pacemaker replacement (pacemaker wire cultures negative) and treatment with daptomycin followed by dalbavancin (9 weeks) | Cure (1 year) |
60 | 1 | Native mitral valve IE in a patient with a prosthetic aortic valve | AC24 | No/No | Treatment with teicoplanin (8 weeks) | Cure (1 year) |
68 | 3 | Early prosthetic mitral and aortic valve IE in a patient with a pacemaker | AC24 | No/No | Treatment with ampicillin (6 weeks) plus gentamicin (2 weeks). | Cure (1 year) |
73 | 4 | Native mitral valve IE | AC24 | No/No | Treatment with ampicillin (6 weeks) plus gentamicin (2 weeks). Second relapse and treatment with ampicillin plus teicoplanin followed by amoxicillin plus moxifloxacin (10 weeks) | Cure (1 year) |
81 | 4 | Native mitral and aortic valve IE with pseudoaneurysm of the radial and femoral arteries | AC24 | No/No | Treatment with ampicillin plus ceftriaxone (6 weeks) and cardiac surgery | Cure (1 year) |
88 | 5 | Native mitral and prosthetic aortic valve complicated IE with pseudoaneurysm of the mitral-aortic intervalvular fibrosa | AC joined | Yes/No | Relapsed and death | Death (2 months) |
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Herrera-Hidalgo, L.; Lomas-Cabezas, J.M.; López-Cortés, L.E.; Luque-Márquez, R.; López-Cortés, L.F.; Martínez-Marcos, F.J.; de la Torre-Lima, J.; Plata-Ciézar, A.; Hidalgo-Tenorio, C.; García-López, M.V.; et al. Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT. J. Clin. Med. 2022, 11, 7. https://doi.org/10.3390/jcm11010007
Herrera-Hidalgo L, Lomas-Cabezas JM, López-Cortés LE, Luque-Márquez R, López-Cortés LF, Martínez-Marcos FJ, de la Torre-Lima J, Plata-Ciézar A, Hidalgo-Tenorio C, García-López MV, et al. Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT. Journal of Clinical Medicine. 2022; 11(1):7. https://doi.org/10.3390/jcm11010007
Chicago/Turabian StyleHerrera-Hidalgo, Laura, Jose Manuel Lomas-Cabezas, Luis Eduardo López-Cortés, Rafael Luque-Márquez, Luis Fernando López-Cortés, Francisco J. Martínez-Marcos, Javier de la Torre-Lima, Antonio Plata-Ciézar, Carmen Hidalgo-Tenorio, Maria Victoria García-López, and et al. 2022. "Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT" Journal of Clinical Medicine 11, no. 1: 7. https://doi.org/10.3390/jcm11010007
APA StyleHerrera-Hidalgo, L., Lomas-Cabezas, J. M., López-Cortés, L. E., Luque-Márquez, R., López-Cortés, L. F., Martínez-Marcos, F. J., de la Torre-Lima, J., Plata-Ciézar, A., Hidalgo-Tenorio, C., García-López, M. V., Vinuesa, D., Gutiérrez-Valencia, A., Gil-Navarro, M. V., & De Alarcón, A., on behalf of the Cardiovascular Infectious Study Group of the Andalusian Society of Infectious Diseases. (2022). Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT. Journal of Clinical Medicine, 11(1), 7. https://doi.org/10.3390/jcm11010007