Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

Autor: Garcia-Alvarez L, Sanz M, Marin M, Farinas M, Montejo M, Goikoetxea J, Garcia R, de Alarcon A, Almela M, Fernandez-Hidalgo N, Socas M, Goenaga M, Navas E, Vicioso L, Oteo J, Adan I, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Bereciartua E, Boado M, Lazaro M, Goiti J, Hernandez J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Perez P, Rodriguez R, Voces R, Lopez M, Georgieva R, Solero M, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Marrero D, Duran M, Gomez M, La Calzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Asensio M, Ambrosioni J, Armero Y, Azqueta M, Brunet M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Gatell J, Perez J, Manzardo C, Marco F, Miro J, Moreno A, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sitges M, Soy D, Tellez A, Vidal B, Vila J, Bermejo J, Bouza E, Cuerpo G, de Egea V, Eworo A, Cruz A, Leoni M, del Vecchio M, Ramallo V, Hernandez M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Moreno E, Antorrena I, Loeches B, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Castillo C, Arnaiz A, Berrazueta J, Bellisco S, Belaustegui M, Duran R, Farinas-Alvarez C, Mazarrasa C, Izquierdo R, Rico C, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Pavia P, Gonzalez J, Orden B, Ramos A, Gonzalez E, Centella T, Hermida J, Moya J, Martin-Davila P, Oliva E, del Rio A, Ruiz S, Tenorio C, de Castro A, de Cueto M, Gallego P, Acebal J, Bano J, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Nacle M, Sanchez-Porto A, Vallejo L, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Serrano P, Roca J, Escobar E, Monje A, Cabrera V, Garcia D, Luna C, Morcillo J, Seco M, Spanish Collaboration Endocarditis
Rok vydání: 2019
Zdroj: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
ISSN: 0305-7453
Popis: Objectives: Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en Espana (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei. Patients and methods: Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options. Results: Follow-up data were obtained from 14 patients. The median follow-up was 46.5months. All patients completed the antibiotic treatment prescribed, with a median duration of 13months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13months), four with doxycycline + hydroxychloroquine (median duration 13.8months) and four with other treatment options (median duration 22.3months). The follow-up after the end of the treatments was between 5 and 84months (median 24months). Conclusions: All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.
Databáze: OpenAIRE
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