Prospective evaluation of a two-week course of intravenous antibiotics in intravenous drug addicts with infective endocarditis. Grupo de Estudio de Enfermedades Infecciosas de la Provincia de Cádiz.
In a prospective study, a two-week course of antibiotics (cloxacillin 2 g/4 h plus amikacin 7.5 mg/kg/12 h) was evaluated in the therapy of right-sided infective endocarditis in intravenous drug users (IVDU). All IVDU admitted to hospital during the study period who fulfilled the strict criteria for diagnosis of infective endocarditis were analysed. A subgroup of patients with right-sided endocarditis caused by Staphylococcus aureus who had a good prognosis were selected as being eligible for the two-week course of treatment. In a total of 139 episodes of infective endocarditis in IVDU, 72 (51.8%) cases were eligible for the two-week treatment. Of this group, 67 were cured, 4 needed prolongation of treatment to cure the infection and 1 died in hospital of respiratory distress syndrome on day 10 of treatment. In patients not eligible for the two-week treatment, the mortality was higher (24.2% versus 0.7%; p = 0.00015). Drug toxicity in the treated group was low. It can be concluded that administration of cloxacillin and amikacin parenterally for 14 consecutive days was successful in the therapy of right-sided endocarditis in IVDU.
Torres-Tortosa
M
M
Infectious Diseases Unit, Hospital Punta de Europa, Algeciras (Cádiz), Spain.
de Cueto
M
M
Vergara
A
A
Sánchez-Porto
A
A
Pérez-Guzmán
E
E
González-Serrano
M
M
Canueto
J
J
D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D003023:Cloxacillin / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D015819:Substance Abuse, Intravenous / Q000150:complications*
D000583:Amikacin; D003023:Cloxacillin