Gentamicin may have no effect on mortality of staphylococcal prosthetic valve endocarditis.
J Infect Chemother
; 24(7): 555-562, 2018 Jul.
Article
em En
| MEDLINE
| ID: mdl-29628387
ABSTRACT
PURPOSE:
To analyze the influence of adding gentamicin to a regimen consisting of ß-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE).METHODS:
From January 2008 to September 2016, 334 patients with definite SPVE were attended in the participating hospitals. Ninety-four patients (28.1%) received treatment based on ß-lactam or vancomycin plus rifampicin and were included in the study. Variables were analyzed which related to patient survival during admission, including having received treatment with gentamicin.RESULTS:
Seventy-seven (81.9%) were treated with cloxacillin (or vancomycin) plus rifampicin plus gentamicin, and 17 patients (18.1%) received the same regimen without gentamicin. The causative microorganism was Staphylococcus aureus in 40 cases (42.6%) and coagulase-negative staphylococci in 54 cases (57.4%). Overall, 40 patients (42.6%) died during hospital admission, 33 patients (42.9%) in the group receiving gentamicin and 7 patients in the group that did not (41.2%, P = 0.899). Worsening renal function was observed in 42 patients (54.5%) who received gentamicin and in 9 patients (52.9%) who did not (p = 0.904). Heart failure as a complication of endocarditis (OR 4.58; CI 95% 1.84-11.42) and not performing surgery when indicated (OR 2.68; CI 95% 1.03-6.94) increased mortality. Gentamicin administration remained unrelated to mortality (OR 1.001; CI 95% 0.29-3.38) in the multivariable analysis.CONCLUSIONS:
The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Estafilocócicas
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Próteses Valvulares Cardíacas
/
Gentamicinas
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Infecções Relacionadas à Prótese
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Endocardite Bacteriana
/
Antibacterianos
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article