Use of teicoplanin monotherapy for the treatment of enterococcal infective endocarditis: a retrospective and comparative study at a referral centre.

Autor:	Villamarín M; Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Campus Hospitalari, Passeig de la Vall d'Hebron 119-129, Barcelona 08035, Spain.; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain., Fernández-Hidalgo N; Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Campus Hospitalari, Passeig de la Vall d'Hebron 119-129, Barcelona 08035, Spain.; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.; CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain., Viñado B; Servei de Microbiologia, Hospital Universitari Vall d'Hebron, Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Campus Hospitalari, Passeig de la Vall d'Hebron 119-129, Barcelona 08035, Spain., González-López JJ; CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.; Servei de Microbiologia, Hospital Universitari Vall d'Hebron, Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Campus Hospitalari, Passeig de la Vall d'Hebron 119-129, Barcelona 08035, Spain.; Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain., Rello P; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.; Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Campus Hospitalari, Passeig de la Vall d'Hebron 119-129, Barcelona 08035, Spain., Escolà-Vergé L; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.; CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.; Unitat de Malalties Infeccioses, Servei de Medicina Interna, Hospital de la Santa Creu i Sant Pau, Barcelona, Institut de Recerca Sant Pau, Sant Pau Campus Salut Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2024 Nov 04; Vol. 79 (11), pp. 2809-2814.
DOI:	10.1093/jac/dkae291
Abstrakt:	Objectives: Clinical experience in the use of teicoplanin for treating enterococcal infective endocarditis (EIE) is scarce. The aim of this study was to describe the characteristics and outcomes of patients with EIE treated with teicoplanin monotherapy compared to standard therapy with ampicillin plus ceftriaxone. Methods: All consecutive adult patients diagnosed with EIE between January 2018 and September 2022 at a referral centre were reviewed. Characteristics of individuals treated with teicoplanin for ≥14 days [the treated with teicoplanin (TT) group] were compared with those who received ampicillin plus ceftriaxone (AC group). Results: Sixty-six patients were included [61 (92%) E. faecalis infective endocarditis (IE) and 5 (8%) E. faecium IE]. Twenty-seven (41%) received teicoplanin: eight as first-line treatment and 19 as continuation therapy.The median duration of teicoplanin treatment was 30 (25-43) days. Surgery was indicated in 14/27 (52%) in the TT group and in 21/39 (54%) in the AC group, but was finally performed in 11/14 (79%) and 13/21 (62%) (P = 0.46), respectively. In-hospital mortality rate was 3/27 (11%) in the TT group and 12/39 (31%) in the AC group (P = 0.06). Patients treated with teicoplanin were more often discharged on outpatient parenteral antibiotic therapy [18/27 (67%) versus 6/39 (15%), P < 0.001] and median hospital stay was shorter [29 days (IQR 20-61) versus 50 days (IQR 43-68), P = 0.006]. One-year cumulative mortality was 8/27 (30%) in the TT group and 13/39 (33%) in the AC group (P = 0.46). There was one relapse in each group. Conclusion: Teicoplanin seems an effective treatment for selected patients with enterococcal IE, mainly to facilitate discharge. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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