Evaluation of antibiotic therapy following valve replacement for native valve endocarditis.
We retrospectively evaluated 105 patients at the Mayo Clinic between 1970 and 2006 with native valve endocarditis who underwent acute valve surgery. The objective was to determine if outcomes differed based on whether they had received an antibiotic regimen recommended for native valve endocarditis or one for prosthetic valve endocarditis. Fifty-two patients had streptococcal and 53 had staphylococcal infections. Patients with each type of infection were divided into two groups: the first received postoperative monotherapy (with a beta-lactam or vancomycin), and the second received combination therapy (with an aminoglycoside for streptococcal infection, and gentamicin and/or rifampin for staphylococcal infection). The duration and types of antibiotics given pre- and postoperatively, valve cultures results, antibiotic-related adverse events, relapses, and mortality rates within 6 months of surgery were analyzed. Cure rates were similar regardless of the regimen administered. With the small number of patients in each group, a multicenter study with a larger cohort of patients is needed to better define optimal postoperative treatment regimens in this population.
Fadel
H J
HJ
Department of Medicine, Division of Infectious Diseases, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. fadel.hind@mayo.edu
Tleyjeh
I M
IM
Steckelberg
J M
JM
Wilson
W R
WR
Baddour
L M
LM
D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D013290:Streptococcal Infections / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use; D047090:beta-Lactams / Q000627:therapeutic use
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D014640:Vancomycin; D012293:Rifampin
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