Safety and Tolerability of More than Six Days of Tedizolid Treatment.

Tedizolid has demonstrated its efficacy and safety in clinical trials; however, data concerning its tolerability in long-term treatments are scarce. The aim of the study was to assess the indications and to describe the long-term safety profile of tedizolid. A multicentric retrospective study of patients who received tedizolid for more than 6 days was conducted. Adverse events (AEs) were identified from patients' medical records and laboratory data. The World Health Organization causality categories were used to discern AEs that were probably associated with tedizolid. Eighty-one patients, treated with tedizolid 200 mg once daily for a median (interquartile range [IQR]) duration of 28 (14 to 59) days, were included; 36 (44.4%) had previously received linezolid. The most common reasons for selecting tedizolid were to avoid linezolid potential toxicities or interactions (53.1%) or due to previous linezolid-related toxicities (27.2%). The most common indications were off-label, including prosthetic joint infections, osteomyelitis, and respiratory infections (77.8%). Overall, 9/81 patients (11.1%) experienced a probably associated AE. Two patients (2.5%) developed gastrointestinal disorders, 1 (1.2%) developed anemia, and 6 developed thrombocytopenia (7.4%) after a median (IQR) duration of treatment of 26.5 (17 to 58.5) days. Four (5%) patients discontinued tedizolid due to AEs. Among 23 patients with chronic renal failure (CRF), the rate of myelotoxicity was 17.4%, and only 8.7% had to stop tedizolid; 20 out of 22 with previous linezolid-associated toxicity had no AE. Long-term tedizolid treatments had good tolerance with rates of gastrointestinal AE and hematological toxicity lower than those reported with linezolid, particularly in patients with CRF and in those with a history of linezolid-associated toxicity.

[Associated factors and descriptive analysis of healthcare-related infective endocarditis in a tertiary reference hospital]. / Factores asociados y análisis descriptivo de la endocarditis infecciosa adquirida en el entorno hospitalario de un centro terciario de referencia.

INTRODUCTION AND OBJECTIVES: The primary aim of this study was to evaluate associated factors, clinical features and prognosis of healthcare-related infective endocarditis cases compared with community-acquired and intravenous drug user-related episodes. Changes in the distribution of healthcare-related infective endocarditis were also analysed over time in our setting. METHODS: A prospective, observational, comparative study was performed. We included all the cases of infective endocarditis from January 2003 to June 2010, which were then classified into 2 groups: group 1: community-acquired and intravenous drug user origin, and group 2: nosocomial and non-nosocomial healthcare-related cases. The episodes were classified into 2 periods: period I: January/2003-June/2006 and period II: July/2006-June 2010. Univariate and multivariate analyses were performed. RESULTS: A total of 212 cases were included (group 1: 138, group 2: 74). The variables of age (risk ratio 1.026; 95%CI, 1.003 to 1.049), Charlson index (risk radio 1.242; 95%CI, 1.067 to 1.445), and previous heart surgery (risk ratio 2.522; 95%CI, 1.353 to 4.701) were independently associated with healthcare-related infective endocarditis on multivariate analysis. A non-significant increase was observed in healthcare-related cases of infective endocarditis in period II (40/104; 38.4% vs. 34/108; 31.4%). CONCLUSIONS: The recent increase in healthcare-related infective endocarditis seems to be associated with the use of invasive procedures in elderly patients with prosthetic cardiac valve, and those with a greater number of underlying diseases, especially patients with chronic renal failure on haemodialysis.

Factores asociados y análisis descriptivo de la endocarditis infecciosa adquiridaen el entorno hospitalario de un centro terciario de referencia / Associated factors and descriptive analysis of healthcare-related infective endocarditis in a tertiary reference hospital

Introducción y objetivos: Nuestro objetivo primario es evaluar los factores asociados, las manifestaciones clínicas y el pronóstico de la endocarditis infecciosa adquirida en el entorno hospitalario comparándola con la adquirida en la comunidad y en usuarios de drogas por vía parenteral. Como objetivo secundario se analizan cambios ocurridos en el tiempo en la distribución de la endocarditis infecciosa adquirida en el entorno hospitalario. Métodos: Se realizó un estudio prospectivo observacional y comparativo que incluyó los casos de endocarditis desde enero de 2003 a junio de 2010 y se clasiflcaron en 2 grupos; grupo 1: comunidad y usuarios de drogas por vía parenteral, y grupo 2: adquirida en el entorno hospitalario (nosocomial y nosohusial).Los episodios fueron clasiflcados en 2 periodos (periodo I: enero de 2003-junio de 2006, y periodo II: juliode 2006-junio de 2010). Se efectuó un análisis univariado y multivariado. Resultados: Se incluyeron 212 episodios (grupo 1: 138; grupo 2: 74). La edad (OR, 1,026; IC del 95%,1,003-1,049), el índice de Charlson (OR, 1,242; IC del 95%, 1,067-1,445) y la cirugía cardiaca previa (OR,2,522; IC del 95%, 1,353-4,701) fueron variables asociadas a la endocarditis infecciosa adquirida en el entorno hospitalario en el estudio multivariado. Se observó un incremento no signiflcativo de casos de endocarditis infecciosa adquirida en el entorno hospitalario en el periodo II (40/104; 38,4% vs. 34/108;31,4%).Conclusiones: El incremento reciente de la endocarditis infecciosa adquirida en el entorno hospitalario se asocia sin duda al intervencionismo sobre pacientes mayores, portadores de prótesis valvular cardíaca y que además tienen un mayor número de enfermedades de base, entre las que destaca la insuflciencia renal crónica en hemodiálisis (AU)

Introduction and objectives: The primary aim of this study was to evaluate associated factors, clinical features and prognosis of healthcare-related infective endocarditis cases compared with community acquired and intravenous drug user-related episodes. Changes in the distribution of healthcare-related infective endocarditis were also analysed over time in our setting. Methods: A prospective, observational, comparative study was performed. We included all the cases of infective endocarditis from January 2003 to June 2010, which were then classifled into 2 groups: group 1:community-acquired and intravenous drug user origin, and group 2: nosocomial and non-nosocomial healthcare-related cases. The episodes were classifled into 2 periods: period I: January/2003-June/2006and period II: July/2006-June 2010. Univariate and multivariate analyses were performed. Results: A total of 212 cases were included (group 1: 138, group 2: 74). The variables of age (risk ratio1.026; 95% CI, 1.003 to 1.049), Charlson index (risk radio 1.242; 95% CI, 1.067 to 1.445), and previous heartsurgery (risk ratio 2.522; 95% CI, 1.353 to 4.701) were independently associated with healthcare-related infective endocarditis on multivariate analysis. A non-signiflcant increase was observed in health carerelated cases of infective endocarditis in period II (40/104; 38.4% vs. 34/108; 31.4%).Conclusions: The recent increase in healthcare-related infective endocarditis seems to be associated with the use of invasive procedures in elderly patients with prosthetic cardiac valve, and those with a greater number of underlying diseases, especially patients with chronic renal failure on haemodialysis (AU)

Síndrome hemofagocítico asociado a tuberculosis diseminada / Hemophagocytic syndrome associated with disseminated tuberculosis

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Tuberculosis peritoneal. Estudio de cuatro casos / Peritoneal tuberculosis. Study of four patients

No disponible