Abstract | BACKGROUND: It is often difficult to administer extended antibiotic therapy in the hospital for right-sided Staphylococcus aureus endocarditis. Although the effectiveness of single- drug therapy given for 4 to 6 weeks and that of two- drug therapy given for 2 weeks have been shown, no data are available on the effectiveness of short-course single- drug therapy. OBJECTIVE: DESIGN: Open, randomized study. SETTING: An academic tertiary care hospital in Barcelona, Spain. PATIENTS: 90 consecutive intravenous drug users who had isolated tricuspid valve endocarditis caused by methicillin-susceptible S. aureus, had no allergy to study medications, and had no systemic infectious complications that required prolonged therapy. An efficacy subset consisted of 74 of these patients who did not meet an exclusion criterion. INTERVENTION: MEASUREMENTS: RESULTS: In an analysis of the efficacy subset, treatment was successful in 34 of the 38 patients who received cloxacillin alone (89% [95% CI, 75% to 97%]) and 31 of the 36 patients who received cloxacillin plus gentamicin (86% [CI, 71% to 95%]). Three patients died: one in the cloxacillin group and two in the combination therapy group. Of the 37 patients who completed 2-week treatment with cloxacillin, 34 (92%) were cured, and 3 (8%) needed prolonged treatment to cure the infection. Of the 34 patients who completed 2-week treatment with cloxacillin plus gentamicin, 32 (94%) were cured and 2 (6%) required treatment for 4 weeks. One patient in the combination group had relapse. CONCLUSIONS:
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Authors | E Ribera, J Gómez-Jimenez, E Cortes, O del Valle, A Planes, T Gonzalez-Alujas, B Almirante, I Ocaña, A Pahissa |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 125
Issue 12
Pg. 969-74
(Dec 15 1996)
ISSN: 0003-4819 [Print] United States |
PMID | 8967707
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anti-Bacterial Agents
- Gentamicins
- Penicillins
- Cloxacillin
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Topics |
- Anti-Bacterial Agents
(therapeutic use)
- Cloxacillin
(therapeutic use)
- Drug Administration Schedule
- Drug Therapy, Combination
- Endocarditis, Bacterial
(complications, drug therapy)
- Follow-Up Studies
- Gentamicins
(therapeutic use)
- Humans
- Penicillins
(therapeutic use)
- Staphylococcal Infections
(complications, drug therapy)
- Substance Abuse, Intravenous
(complications)
- Treatment Outcome
- Tricuspid Valve
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