Enterococcus faecalis Infective Endocarditis: A Pilot Study of the Relationship Between Duration of Gentamicin Treatment and Outcome

Because of the nephrotoxic effects of aminoglycosides, the Danish guidelines on infective endocarditis were changed in January 2007, reducing gentamicin treatment in enterococcal infective endocarditis from 4 to 6 weeks to only 2 weeks. In this pilot study, we compare outcomes in patients with Enter...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2013-04, Vol.127 (17), p.1810-1817
Main Authors: DAHL, Anders, RASMUSSEN, Rasmus V, BUNDGAARD, Henning, HASSAGER, Christian, BRUUN, Louise E, LAURIDSEN, Trine K, MOSER, Claus, SOGAARD, Peter, ARPI, Magnus, BRUUN, Niels E
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cohort Studies
Denmark - epidemiology
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Endocardial and cardiac valvular diseases
Endocarditis, Bacterial - diagnosis
Endocarditis, Bacterial - drug therapy
Endocarditis, Bacterial - epidemiology
Enterococcus faecalis - isolation & purification
Female
Follow-Up Studies
Gentamicins - therapeutic use
Gram-Positive Bacterial Infections - diagnosis
Gram-Positive Bacterial Infections - drug therapy
Gram-Positive Bacterial Infections - epidemiology
Heart
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Pilot Projects
Prospective Studies
Registries
Retrospective Studies
Treatment Outcome
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Summary:Because of the nephrotoxic effects of aminoglycosides, the Danish guidelines on infective endocarditis were changed in January 2007, reducing gentamicin treatment in enterococcal infective endocarditis from 4 to 6 weeks to only 2 weeks. In this pilot study, we compare outcomes in patients with Enterococcus faecalis infective endocarditis treated in the years before and after endorsement of these new recommendations. A total of 84 consecutive patients admitted with definite left-sided E faecalis endocarditis in the period of 2002 to 2011 were enrolled. Forty-one patients were treated before and 43 patients were treated after January 1, 2007. There were no significant differences in baseline characteristics. At hospitalization, the 2 groups had similar estimated glomerular filtration rates of 66 and 75 mL/min (P=0.22). Patients treated before January 2007 received gentamicin for a significantly longer period (28 versus 14 days; P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.112.001170