使用替考拉宁单药治疗肠球菌感染性心内膜炎:一项在转诊中心进行的回顾性比较研究。

IF 3.9 2区 医学 Q1 INFECTIOUS DISEASES
Miguel Villamarín, Nuria Fernández-Hidalgo, Belén Viñado, Juan José González-López, Pau Rello, Laura Escolà-Vergé
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引用次数: 0

摘要

目的:使用替考拉宁治疗肠球菌感染性心内膜炎(EIE)的临床经验很少。本研究旨在描述与氨苄西林加头孢曲松的标准疗法相比,使用替考拉宁单药治疗EIE患者的特点和疗效:对一家转诊中心在2018年1月至2022年9月期间诊断为EIE的所有连续成年患者进行了回顾性研究。将接受替考拉宁治疗≥14天的患者[接受替考拉宁治疗组(TT组)]与接受氨苄西林加头孢曲松治疗的患者(AC组)的特征进行比较:结果:共纳入66例患者[61例(92%)为粪肠球菌感染性心内膜炎(IE)患者,5例(8%)为粪肠球菌IE患者]。27例(41%)患者接受了替考拉宁治疗:8例作为一线治疗,19例作为继续治疗。TT组中有14/27(52%)人有手术指征,AC组中有21/39(54%)人有手术指征,但最终分别有11/14(79%)人和13/21(62%)人接受了手术(P=0.46)。TT组的院内死亡率为3/27(11%),AC组为12/39(31%)(P = 0.06)。接受替考拉宁治疗的患者在出院时更多接受门诊肠外抗生素治疗[18/27(67%)对6/39(15%),P 结论:替考拉宁似乎是一种有效的抗生素:替考拉宁似乎是治疗部分肠球菌 IE 患者的有效方法,主要是为了方便患者出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of teicoplanin monotherapy for the treatment of enterococcal infective endocarditis: a retrospective and comparative study at a referral centre.

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.

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来源期刊
CiteScore
9.20
自引率
5.80%
发文量
423
审稿时长
2-4 weeks
期刊介绍: The Journal publishes articles that further knowledge and advance the science and application of antimicrobial chemotherapy with antibiotics and antifungal, antiviral and antiprotozoal agents. The Journal publishes primarily in human medicine, and articles in veterinary medicine likely to have an impact on global health.
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