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Gentamicin may have no effect on mortality of staphylococcal prosthetic valve endocarditis

2018; Elsevier BV; Volume: 24; Issue: 7 Linguagem: Inglês

10.1016/j.jiac.2018.03.003

1437-7780

António Ramos, Patricia Muñóz, Arístides de Alarcón González, Patricia Muñóz, Ana Fernández‐Cruz, Maricela Valerio, María Carmen Fariñas, Manuel Gutiérrez‐Cuadra, José Ma Miró, Josefa Ruiz‐Morales, Dolores Sousa-Regueiro, José Miguel Montejo, Juan Gálvez-Acebal, Carmen Hidalgo-Tenorio, Fernándo Domínguez, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre, José I. Aramendi, Elena Bereciartúa, Roberto Blanco, María Victoria Boado, Itxasne Cabezón Estébanez, Marta Campaña Lázaro, Josune Goikoetxea, J.J. Goiti, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodríguez, Regino Rodríguez, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruíz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José J. Cuenca‐Castillo, Pedro Llinares, Enrique Míguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa, F.J. Martínez-Moreno, M.M. Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada‐Almeida, Ibrahim Nassar, Antonio Plata, José Ma Reguera Iglesias, Víctor Asensi, Carlos Costas, Jesús de la Hera, Jonathan Fernández-Suarez, Lisardo Iglesias Fraile, Víctor León, José López Menéndez, Pilar Mencía Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, B. Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez-García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Merçè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Marta Hernández‐Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Pié i Ninot, Eduard Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericàs, José Luís Pomar, J. M. Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José Marı́a Tolosana, Bàrbara Vidal, Jordi Vilà, Iván Adán, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Ana Fernández‐Cruz, Ma Eugenia García Leoni, Víctor José González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez‐Sellés, Ma Cruz Menárguez, Patricia Muñóz, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez‐Créixems, Blanca Pinilla, Ángel González Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín‐Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Pilar Romero‐Gómez, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnáiz, Francisco Arnaíz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González-Rico, Manuel Gutiérrez‐Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Fernándo Domínguez, Pablo García Pavíaz, Jesús Gonzálezz, Beatriz Ordenz, Antonio Ramosz, Tomasa Centella, José Manuel Hermida, José Luis Betrán Moya, Pilar Martín‐Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruíz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez-Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Arístides de Alarcón, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona, José Ramón Blanco, Lara García-Álvarez, José A. Oteo, Mercedes Sanz, Natividad Benito, Mercè Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, Mar Álvarez, Ángel L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Fernándo Domínguez, Antonio Sánchez-Porto, José María Arribas, Elisa García Vázquez, Alicia Hernández Torres, Ana Lozano-Blázquez, Gonzalo de la Morena, Ángel Cabo Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, Jose Roca, I. Keituqwa Yáñez, Ana Peláez Ballesta, Víctor Soriano, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, Juan Carlos Porres,

Antibiotics Pharmacokinetics and Efficacy

To analyze the influence of adding gentamicin to a regimen consisting of β-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE).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 β-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.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.The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome.