Clinical reality for adjunctive rifampin usage in infective endocarditis treatment

Abstract

AIM

We aimed to determination of the area of adjunctıve rifampin usage in infectıve endocarditis (IE) endocarditis treatment.

BACKGROUND

Current International infective endocarditis guidelines recommend rifampin-based combination treatments for staphylococcal prosthetic valve endocarditis (PVE). It is also a frequently used agent in the treatment of culture-negative endocarditis and brucella endocarditis. Because the rifampin tolerability is an important issue, full compliance with the guidelines in treatment management may not always be achieved.

METHODS

This study was a multicenter, retrospective cohort study, performed between 2019-2023. The patients used rifampin based combinations (RBC) were included in the study. Demographic, imaging, microbiological and clinical data were recorded. Descriptive statistical analysis was performed.

RESULTS

Between January 2019 and December 2023; a total of 506 IE cases were detected. A total of 59 patients used RBC during treatment. The median duration of rifampin treatment in these patients was 34.5(2-200) days. 28 of these patients were staphylococcal endocarditis (20 prosthetic valve IE, 5 cardiac implanted electronic device IE, 3 native valve IE). Fourteen (23.7%) of these patients were followed-up as culture negative IE. The patients diagnosed with The median duration of RBC in brucella endocarditis patients (6) was 139(20-180) days. RBC was not used in 58.7% of patients with prosthetic staphylococcal infective endocarditis. Although not compliant with guideline recommendations, RBC was used in 11 patients with a median duration of 20 days.

CONCLUSION

In order to determine the areas of use of rifampin, which is difficult to tolerate and has many drug interactions, in the treatment of endocarditis, needs further validation.