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Teicoplanin for treating enterococcal infective endocarditis: A retrospective observational study from a referral centre in Spain.

Abstract：

:This study aimed to evaluate the effectiveness and safety of teicoplanin for treating enterococcal infective endocarditis (EIE). A retrospective analysis of a prospective cohort of definite EIE patients treated with teicoplanin in a Spanish referral centre (2000-2017) was performed. The primary outcome was mortality during treatment. Secondary outcomes were mortality during 3-month follow-up, adverse effects and relapse. A total of 22 patients received teicoplanin, 9 (40.9%) as first-line (8 Enterococcus faecium and 1 Enterococcus faecalis) and 13 (59.1%) as salvage therapy (13 E. faecalis). Median (IQR) age was 71.5 (58.3-78) years and Charlson comorbidity index was 4.5 (3-7). Five (22.7%) affected prosthetic valves. Median duration of treatment in survivors was 53 (42.5-61) days for antibiotics and 27 (17-41.5) days for teicoplanin [median dose 10 (10-10.8) mg/kg/day]. Reasons for teicoplanin use were resistance to β-lactams (40.9%), adverse events with previous regimens (31.8%) and outpatient parenteral antimicrobial therapy (OPAT) (27.3%). Teicoplanin was withdrawn due to adverse events in 2 patients (9.1%). Five patients (22.7%) died during treatment: four in the first-line (three with surgery indicated but not performed) and one in the salvage therapy group (surgery indicated but not performed). Two deaths (11.8%) occurred over the 3-month follow-up. There were no relapses during a median of 43.2 (22.1-69.1) months. Teicoplanin can be used as an alternative treatment for susceptible E. faecium IE and as a salvage therapy in selected patients with E. faecalis IE when adverse events develop with standard regimens or to allow OPAT.

journal_name

Int J Antimicrob Agents

journal_title

International journal of antimicrobial agents

authors

Escolà-Vergé L,Fernández-Hidalgo N,Rodríguez-Pardo D,Pigrau C,González-López JJ,Bartolomé R,Almirante B

doi

10.1016/j.ijantimicag.2018.10.003

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

165-170

issue

eissn

0924-8579

issn

1872-7913

pii

S0924-8579(18)30295-4

journal_volume

pub_type

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Teicoplanin for treating enterococcal infective endocarditis: A retrospective observational study from a referral centre in Spain.