Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

Camazón, Nuria Vallejo; Mateu, Lourdes; Cediel, Germán; Escolà-Vergé, Laura; Fernández-Hidalgo, Núria; Ferrer, Mercedes Gurgui; Rodríguez, María Teresa Pérez; Cuervo, Guillermo; Aragón, Raquel Núñez; Llibre, Cinta; Sopena, Nieves; Quesada, María Dolores; Berastegui, E.; Teis, Albert; Ayerbe, J. Lopez; Juncà, Gladys; Gual, Francisco; Sistach, Elena Ferrer; Vivero, Ainhoa; Reynaga, Esteban; Pérez, Maria Hernández; Guijosa, Christian Muñoz; Pedro-Botet, Lluisa; Bayés‐Genís, Antoni

doi:10.5603/cj.a2021.0054

Cited by 18 publications

(7 citation statements)

References 49 publications

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“…(iii) Monitoring response to antimicrobial treatment with [18F] FDG-PET/CT in patients with established IE and indication for surgery but who cannot be operated on due to unacceptable high risk and remain with long-term suppressive antibiotic treatment. 137,184,[229][230][231][232][233][234][235][236] Recommendation Table 6 -Recommendations for the role of computed tomography, nuclear imaging, and magnetic resonance in infective endocarditis…”

Section: Nuclear Imaging Positron Emission Tomography/computed Tomogr...mentioning

confidence: 99%

“…(viii) Data on the efficacy of long-term antibiotic suppressive therapy in patients with IE who do not undergo cardiac surgery are limited to small and heterogeneous series with various antibiotic regimens. 184,274 In a small series of Gram-positive bloodstream infections and IE, dalbavancin (500 mg weekly or 1000 mg biweekly regimens) has been shown effective. 274,275 Relapses are not infrequent.…”

Section: General Principlesmentioning

confidence: 99%

See 1 more Smart Citation

ESC guidelines 2023 on the management of endocarditis

de Waha,

Desch,

Tilz

et al. 2023

Herz

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Section: Nuclear Imaging Positron Emission Tomography/computed Tomogr...mentioning

confidence: 99%

Section: General Principlesmentioning

confidence: 99%

ESC guidelines 2023 on the management of endocarditis

de Waha,

Desch,

Tilz

et al. 2023

Herz

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show abstract

“…Four of these patients experienced a relapse during the 8 years follow-up, but one of them had stopped the suppressive therapy, and another one had developed a resistance. 30 At the time of writing, there is no recommendation for suppressive therapy and, through our work, it seems this treatment could be a key treatment to avoid relapses, especially in patients with a higher risk of recurrence.…”

Section: Discussionmentioning

confidence: 87%

Enterococcal endocarditis management and relapses

Garofoli,

Joly,

Le Pluart

et al. 2024

JAC-Antimicrobial Resistance

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Introduction Enterococcus faecalis is the third micro-organism causing endocarditis and is associated with a significant relapse rate. The objective of this study was to describe the management of patients with Enterococcus faecalis endocarditis (EE) and its implication for relapses. Methods We conducted a monocentric, retrospective analysis of all patients hospitalized for EE including endocarditis or infection of cardiac implantable electronic device defined by the modified ESC 2015 Duke criteria in a referral centre in Paris, France. Results Between October 2016, and September 2022, 54 patients with EE were included, mostly men (n = 40, 74%) with a median age of 75 [68–80] years. A high risk for infective endocarditis (IE) was found in 42 patients (78%), including 14 (26%) previous histories of IE, and 32 (59%) histories of valvular cardiac surgery. The aortic valve was the most frequently affected (n = 36, 67%). Combination therapy was mainly amoxicillin-ceftriaxone during all the curative antibiotic therapy duration (n = 31, 57%). Surgery was indicated for 40 patients (74%), but only 27 (50%) were operated on, mainly due to their frailty. Among the 17 deaths (32%), six (11%) happened during the first hospitalization for EE. A suppressive antibiotic treatment was initiated in 15 (29%) patients, mostly because of not performing surgery. During the 6-year study period an EE relapse occurred in three (6%) patients. Conclusions EE is a worrying disease associated with a high risk of relapse and significant mortality. Suppressive antibiotic therapy could be a key treatment to limit the occurrence of relapses.

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“…There are some instances where antibiotics alone do not control the infection, and surgery is required to remove or fix vegetation and abscesses and even remove implanted valves or devices [ 7 ]. To an extent, when surgery is not advised despite indications, these patients may end up on long-term oral suppressive antibiotic treatment, which could continue for a median of 277 days [ 10 ]. Despite the improvement of therapy and treatment, reinfection with IE is found to be up to 5-10% [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Risk of Infective Endocarditis Post-transcatheter Pulmonary Valve Replacement Versus Surgical Pulmonary Valve Replacement: A Systematic Review

Slouha,

Johnson,

Thirunavukarasu

et al. 2023

Cureus

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Pulmonary valve replacement (PVR) is the most common cardiac operation in adult patients with congenital heart disease (ACHD). It can improve right ventricular outflow tract (RVOT) obstruction, typically due to pulmonary valve stenosis or regurgitation. PVR can be performed surgically (open-heart) and through a transcatheter (percutaneous) method, which is minimally invasive and is associated with shorter hospitalization stays. However, following PVR, infectious endocarditis (IE) can complicate the recovery process and increase mortality in the long term. IE is a rare but deadly multi-organ system condition caused by microorganisms traversing the bloodstream from a specific entry point. It can have many presentations, such as splinter hemorrhages, fevers, and vegetation on valves that lead to stroke consequences. This paper aims to evaluate the differences in the rate, etiology, manifestations, treatment, and outcomes of IE following surgical and transcatheter PVR, as the goal is to perform a procedure with few complications. In both approaches, Staphylococcus aureus was the most common microorganism that affected the valves, followed by Streptococcus viridians . Research has shown that surgical pulmonary valve replacement (SPVR) has a decreased risk of IE following surgery compared to TPVR. However, TPVR is preferred due to the reduced overall risk and complications of the procedure. Despite this, the consensus on mortality rates does differ. Future research should consider the type of valves used for transcatheter pulmonary valve replacement (TPVR), such as Melody valves versus Edward Sapien valves, as their IE rates vary significantly.

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Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Cardiology Journal" are listed in PubMed.

Cited by 18 publications

References 49 publications

ESC guidelines 2023 on the management of endocarditis

ESC guidelines 2023 on the management of endocarditis

Enterococcal endocarditis management and relapses

Risk of Infective Endocarditis Post-transcatheter Pulmonary Valve Replacement Versus Surgical Pulmonary Valve Replacement: A Systematic Review

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