Abstract | BACKGROUND: METHODS AND RESULTS: A total of 84 consecutive patients admitted with definite left-sided E faecalis endocarditis in the period of 2002 to 2011 were enrolled. Forty-one patients were treated before and 43 patients were treated after January 1, 2007. There were no significant differences in baseline characteristics. At hospitalization, the 2 groups had similar estimated glomerular filtration rates of 66 and 75 mL/min (P=0.22). Patients treated before January 2007 received gentamicin for a significantly longer period (28 versus 14 days; P<0.001). The primary outcome, 1-year event-free survival, did not differ: 66% versus 69%, respectively (P=0.75). At discharge, the patients treated before 2007 had a lower estimated glomerular filtration rate (45 versus 66 mL/min; P=0.008) and a significantly greater decrease in estimated glomerular filtration rate (median, 11 versus 1 mL/min; P=0.009) compared with those treated after 2007. CONCLUSIONS: Our present pilot study suggests that the recommended 2-week treatment with gentamicin seems adequate and preferable in treating non-high-level aminoglycoside-resistant E faecalis infective endocarditis. The longer duration of gentamicin treatment is associated with worse renal function. Although the certainty of the clinical outcomes is limited by the sample size, outcomes appear to be no worse with the shorter treatment duration. Randomized, controlled studies are warranted to substantiate these results.
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Authors | Anders Dahl, Rasmus V Rasmussen, Henning Bundgaard, Christian Hassager, Louise E Bruun, Trine K Lauridsen, Claus Moser, Peter Sogaard, Magnus Arpi, Niels E Bruun |
Journal | Circulation
(Circulation)
Vol. 127
Issue 17
Pg. 1810-7
(Apr 30 2013)
ISSN: 1524-4539 [Electronic] United States |
PMID | 23543002
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Gentamicins
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Topics |
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(therapeutic use)
- Cohort Studies
- Denmark
(epidemiology)
- Endocarditis, Bacterial
(diagnosis, drug therapy, epidemiology)
- Enterococcus faecalis
(isolation & purification)
- Female
- Follow-Up Studies
- Gentamicins
(therapeutic use)
- Gram-Positive Bacterial Infections
(diagnosis, drug therapy, epidemiology)
- Humans
- Male
- Middle Aged
- Pilot Projects
- Prospective Studies
- Registries
- Retrospective Studies
- Treatment Outcome
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