4
Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE) Multi-centre, observational, non-randomised, comparative cohort study (Spain, Italy; 2005-2011): N=291 adult pts with EFIE Fernández-Hidalgo N et al. Clin Infect Dis 2013;56:1261-8 1 of 2

Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE) Multi-centre, observational,

Embed Size (px)

Citation preview

Page 1: Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE) Multi-centre, observational,

Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE)

• Multi-centre, observational, non-randomised, comparative cohort study (Spain, Italy; 2005-2011): N=291 adult pts with EFIE

Fernández-Hidalgo N et al. Clin Infect Dis 2013;56:1261-8

1 of 2

Page 2: Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE) Multi-centre, observational,

Efficacy

Safety

•Subgroup of pts with EFIE caused by non-HLAR strains: similar results, except for septic paravalvular complications: AC: 40% - AG: 26% (P=0.050)

Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE)

AC seems to have a similar efficacy as AG for treating EFIE patients regardless of HLAR status, but may be less nephrotoxic

Fernández-Hidalgo N et al. Clin Infect Dis 2013;56:1261-8

2 of 2

Page 3: Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE) Multi-centre, observational,

Follow-up (FU) echocardiography after antibiotic therapy for infective endocarditis (IE): impact on retreatment of IE or cardiac valve surgery (CVS)

• Retrospective study (2005-2011): N=239 pts who survived initial treatment (Tx) for definite IE (Duke criteria)

Schutte KM. IDWeek 2013 abs. 621

1 of 2

Page 4: Efficacy of ampicillin plus ceftriaxone vs ampicillin plus gentamicin for Enterococcus faecalis infective endocarditis (EFIE) Multi-centre, observational,

Follow-up (FU) echocardiography after antibiotic therapy for infective endocarditis (IE): impact on retreatment of IE or cardiac valve surgery (CVS)

• In 44 pts with Sx + ECHO: significant correlation between new findings on ECHO and need for retreatment for IE and/or CVS: P=0.002

• In 23 pts requiring retreatment and/or CVS: TEE (71%) more sensitive than TTE (50%) for detecting worsening valve function or infection (P=0.0009)

• Valve type, location and infecting pathogen NOT significantly associated with need for retreatment or CVS

IE patients with Sx at post-Tx FU should undergo TEE to guide decisions regarding retreatment of IE and/or CVS

Schutte KM. IDWeek 2013 abs. 621

2 of 2