Retrospective analysis of endocarditis patients to investigate the eligibility for oral antibiotic treatment in routine daily practice.

Autor: Vroon JC; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Liesdek OCD; Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands., Boel CHE; Department of Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands., Arends JE; Department of Internal Medicine and Infection Diseases, University Medical Center Utrecht, Utrecht, The Netherlands., Niessen FA; Department of Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands., van Heusden HC; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Cramer MJ; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., van der Spoel TIG; Department of Cardiology, Haga Hospital, The Hague, The Netherlands., Chamuleau SAJ; Department of Cardiology, Amsterdam University Medical Center, AMC/University of Amsterdam, Amsterdam, The Netherlands. s.a.j.chamuleau@amsterdamumc.nl.
Jazyk: angličtina
Zdroj: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation [Neth Heart J] 2021 Feb; Vol. 29 (2), pp. 105-110.
DOI: 10.1007/s12471-020-01490-2
Abstrakt: Background: According to the current guidelines of the European Society of Cardiology, patients with left-sided infective endocarditis are treated with intravenous antibiotics for 4-6 weeks, leading to extensive hospital stay and high costs. Recently, the Partial Oral Treatment of Endocarditis (POET) trial suggested that partial oral treatment is effective and safe in selected patients. Here, we investigated if such patients are seen in our daily clinical practice.
Methods: We enrolled 119 adult patients diagnosed with left-sided infective endocarditis in a retrospective, observational study. We identified those that would be eligible for switching to partial oral antibiotic treatment as defined in the POET trial (e.g. stable clinical condition without signs of infection). Secondary objectives were to provide insight into the time until each patient was eligible for partial oral treatment, and to determine parameters of longer hospital stay and/or need for extended intravenous antibiotic treatment.
Results: Applying the POET selection criteria, the condition of 38 patients (32%) was stable enough to switch them to partial oral treatment, of which 18 (47.3%), 8 (21.1%), 9 (23.7%) and 3 patients (7.9%) were eligible for switching after 10, 14, 21 days or 28 days of intravenous treatment, respectively.
Conclusion: One-third of patients who presented with left-sided endocarditis in routine clinical practice were possible candidates for switching to partial oral treatment. This could have major implications for both the patient's quality of life and healthcare costs. These results offer an interesting perspective for implementation of such a strategy, which should be accompanied by a prospective cost-effectiveness analysis.
Databáze: MEDLINE
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