Long-term Oral Suppressive Antimicrobial Therapy in Infective Endocarditis (SATIE Study): An Observational Study.

Autor: Beaumont AL; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France., Mestre F; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France., Decaux S; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France., Bertin C; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France., Duval X; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France.; Center of Clinical Investigations, Inserm, CIC 1425, Bichat Hospital, AP-HP, Paris, France., Iung B; Cardiology Department, Bichat Hospital, AP-HP, Paris, France.; Université Paris-Cité, INSERM LVTS U1148, Paris, France., Rouzet F; Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France.; Université Paris-Cité, INSERM LVTS U1148, Paris, France., Grall N; Bacteriology Department, Bichat Hospital, AP-HP, Paris, France.; Université Paris-Cité, IAME, INSERM, Paris, France., Para M; Department of Cardiac Surgery, Bichat Hospital, AP-HP, Paris, France., Thy M; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France.; EA7323, Pharmacology and Drug Evaluation in Children and Pregnant Women, Université Paris Cité, Paris, France.; Medical and Infectious Diseases ICU, Bichat Claude Bernard University Hospital, Université Paris Cité, AP-HP, Paris, France., Deconinck L; Infectious & Tropical Diseases Department, Bichat Hospital, AP-HP, Paris, France.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Apr 04; Vol. 11 (5), pp. ofae194. Date of Electronic Publication: 2024 Apr 04 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae194
Abstrakt: Background: The role of suppressive antimicrobial therapy (SAT) in infective endocarditis (IE) management has yet to be defined. The objective of this study was to describe the use of SAT in an IE referral center and the patients' outcomes.
Methods: We conducted a retrospective observational study in a French IE referral center (Paris). All patients with IE who received SAT between 2016 and 2022 were included.
Results: Forty-two patients were included (36 male [86%]; median age [interquartile range {IQR}], 73 [61-82] years). The median Charlson Comorbidity Index score (IQR) was 3 (1-4). Forty patients (95%) had an intracardiac device. The most frequent microorganisms were Enterococcus faecalis (15/42, 36%) and Staphylococcus aureus (12/42, 29%). SAT indications were absence of surgery despite clinical indication (28/42, 67%), incomplete removal of prosthetic material (6/42, 14%), uncontrolled infection source (4/42, 10%), persistent abnormal uptake on nuclear imaging (1/42, 2%), or a combination of the previous indications (3/42, 7%). Antimicrobials were mainly doxycycline (19/42, 45%) and amoxicillin (19/42, 45%). The median follow-up time (IQR) was 398 (194-663) days. Five patients (12%) experienced drug adverse events. Five patients (12%) presented with a second IE episode during follow-up, including 2 reinfections (different bacterial species) and 3 possible relapses (same bacterial species). Fourteen patients (33%) in our cohort died during follow-up. Overall, the 1-year survival rate was 84.3% (73.5%-96.7%), and the 1-year survival rate without recurrence was 74.1% (61.4%-89.4%).
Conclusions: SAT was mainly prescribed to patients with cardiac devices because of the absence of surgery despite clinical indication. Five (12%) breakthrough second IE episodes were reported. Prospective comparative studies are required to guide this empirical practice.
Competing Interests: Potential conflicts of interest. L.D. was supported by Gilead for the attendance of 2 conferences. All other authors report no potential conflicts.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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