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Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948-4042. [PMID: 37622656 DOI: 10.1093/eurheartj/ehad193] [Citation(s) in RCA: 186] [Impact Index Per Article: 186.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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Ramos-Martínez A, Muñoz Serrano A, de Alarcón González A, Muñoz P, Fernández-Cruz A, Valerio M, Fariñas MC, Gutiérrez-Cuadra M, Miró JM, Ruiz-Morales J, Sousa-Regueiro D, Montejo JM, Gálvez-Acebal J, HidalgoTenorio C, Domínguez F. Gentamicin may have no effect on mortality of staphylococcal prosthetic valve endocarditis. J Infect Chemother 2018; 24:555-562. [PMID: 29628387 DOI: 10.1016/j.jiac.2018.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/23/2018] [Accepted: 03/06/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To analyze the influence of adding gentamicin to a regimen consisting of β-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE). METHODS From January 2008 to September 2016, 334 patients with definite SPVE were attended in the participating hospitals. Ninety-four patients (28.1%) received treatment based on β-lactam or vancomycin plus rifampicin and were included in the study. Variables were analyzed which related to patient survival during admission, including having received treatment with gentamicin. RESULTS Seventy-seven (81.9%) were treated with cloxacillin (or vancomycin) plus rifampicin plus gentamicin, and 17 patients (18.1%) received the same regimen without gentamicin. The causative microorganism was Staphylococcus aureus in 40 cases (42.6%) and coagulase-negative staphylococci in 54 cases (57.4%). Overall, 40 patients (42.6%) died during hospital admission, 33 patients (42.9%) in the group receiving gentamicin and 7 patients in the group that did not (41.2%, P = 0.899). Worsening renal function was observed in 42 patients (54.5%) who received gentamicin and in 9 patients (52.9%) who did not (p = 0.904). Heart failure as a complication of endocarditis (OR: 4.58; CI 95%: 1.84-11.42) and not performing surgery when indicated (OR: 2.68; CI 95%: 1.03-6.94) increased mortality. Gentamicin administration remained unrelated to mortality (OR: 1.001; CI 95%: 0.29-3.38) in the multivariable analysis. CONCLUSIONS The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome.
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Affiliation(s)
- Antonio Ramos-Martínez
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Universitario Puerta de Hierro, Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Alejandro Muñoz Serrano
- Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
| | - Arístides de Alarcón González
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Grupo de Investigación sobre Enfermedades Infecciosas, Instituto de Biomedicina de Sevilla (IBIS), Universidad de Sevilla / CSIC / Universidad Virgen del Rocío y Virgen Macarena, Sevilla, Spain.
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Spain.
| | - Ana Fernández-Cruz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Maricela Valerio
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - María Carmen Fariñas
- Unidad de Enfermedades Infecciosas Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
| | - Manuel Gutiérrez-Cuadra
- Unidad de Enfermedades Infecciosas Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - José Ma Miró
- Servicio de Enfermedades Infecciosas, Hospital Clinic-IDIBAPS. Universidad de Barcelona, Barcelona, Spain.
| | - Josefa Ruiz-Morales
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Victoria, IBIMA, Málaga, Spain.
| | | | - José Miguel Montejo
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Bilbao, Universidad del País Vasco, País Vasco, Spain.
| | - Juan Gálvez-Acebal
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena Instituto de Biomedicina de Sevilla, IBIS. Universidad de Sevilla, Sevilla, Spain.
| | - Carmen HidalgoTenorio
- Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves, Complejo Hospitalario de Granada, Granada, Spain.
| | - Fernando Domínguez
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
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