Partial oral treatment of endocarditis
| Autor: | Henrik Wiggers, Dan Eik Høfsten, Nikolaj Ihlemann, Christian Hassager, Kurt Fuursted, Claus Moser, Sabine Gill, Henrik Carl Schønheyder, Nis Baun Høst, Bettina Pump, Jens Jørgen Christensen, Eva Korup, Claus Holst-Hansen, Niels Eske Bruun, Jannik Helweg Larsen, Kasper Iversen, Flemming S Rosenvinge, Hanne Elming, Henning Bundgaard |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Aortic valve
Adult Male medicine.medical_specialty medicine.drug_class Antibiotics Administration Oral law.invention Randomized controlled trial law medicine Clinical endpoint Endocarditis Humans Prospective Studies Prospective cohort study Aged Dose-Response Relationship Drug business.industry Endocarditis Bacterial Middle Aged medicine.disease Cardiac surgery Surgery Anti-Bacterial Agents medicine.anatomical_structure Treatment Outcome Infective endocarditis Injections Intravenous Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Iversen, K, Høst, N B, Bruun, N E, Elming, H, Pump, B, Christensen, J J, Gill, S, Rosenvinge, F S, Wiggers, H, Fuursted, K, Holst-Hansen, C, Korup, E, Schønheyder, H C, Hassager, C, Høfsten, D E, Larsen, J H, Moser, C E, Ihlemann, N & Bundgaard, H 2013, ' Partial oral treatment of endocarditis ', American Heart Journal, vol. 165, no. 2, pp. 116-22 . https://doi.org/10.1016/j.ahj.2012.11.006 Iversen, K, Høst, N, Bruun, N E, Elming, H, Pump, B, Christensen, J J, Gill, S, Rosenvinge, F, Wiggers, H, Fuursted, K, Holst-Hansen, C, Korup, E, Schønheyder, H C, Hassager, C, Høfsten, D, Larsen, J H, Moser, C, Ihlemann, N & Bundgaard, H 2013, ' Partial oral treatment of endocarditis ', American Heart Journal, vol. 165, no. 2, pp. 116-22 . https://doi.org/10.1016/j.ahj.2012.11.006 Iversen, K, Høst, N B, Bruun, N E, Elming, H, Pump, B, Christensen, J J, Gill, S, Rosenvinge, F, Wiggers, H, Fuursted, K, Holst-Hansen, C, Korup, E, Schønheyder, H C, Hassager, C, Høfsten, D, Larsen, J H, Moser, C E, Ihlemann, N & Bundgaard, H 2013, ' Partial oral treatment of endocarditis ', American Heart Journal, vol. 165, no. 2, pp. 116-22 . https://doi.org/10.1016/j.ahj.2012.11.006 |
| DOI: | 10.1016/j.ahj.2012.11.006 |
| Popis: | Background Guidelines for the treatment of left-sided infective endocarditis (IE) recommend 4 to 6 weeks of intravenous antibiotics. Conversion from intravenous to oral antibiotics in clinically stabilized patients could reduce the side effects associated with intravenous treatment and shorten the length of hospital stay. Evidence supporting partial oral therapy as an alternative to the routinely recommended continued parenteral therapy is scarce, although observational data suggest that this strategy may be safe and effective. Study Design This is a noninferiority, multicenter, prospective, randomized, open-label study of partial oral treatment with antibiotics compared with full parenteral treatment in left-sided IE. Stable patients (n = 400) with streptococci, staphylococci, or enterococci infecting the mitral valve or the aortic valve will be included. After a minimum of 10 days of parenteral treatment, stable patients are randomized to oral therapy or unchanged parenteral therapy. Recommendations for oral treatment have been developed based on minimum inhibitory concentrations and pharmacokinetic calculations. Patients will be followed up for 6 months after completion of antibiotic therapy. The primary end point is a composition of all-cause mortality, unplanned cardiac surgery, embolic events, and relapse of positive blood cultures with the primary pathogen. Conclusion The Partial Oral Treatment of Endocarditis study tests the hypothesis that partial oral antibiotic treatment is as efficient and safe as parenteral therapy in left-sided IE. The trial is justified by a review of the literature, by pharmacokinetic calculations, and by our own experience. |
| Databáze: | OpenAIRE |
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