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