Outpatient Antimicrobial Therapy for Infective Endocarditis is Safe

Infective endocarditis (IE) is common and is associated with significant mortality, morbidity and health care burden. Outpatient antimicrobial therapy in carefully selected patients, supported by a multidisciplinary team is safe and beneficial for both the patient and the health care system. In this article, we review current literature of outpatient antimicrobial therapy in infective endocarditis and propose that most patients with IE should be considered and appropriate pathways developed to facilitate this.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Review Source Type: research

Related Links:

This study reports four cases ofA. defectiva IE in children and reviews previously reported five pediatric cases ofA. defectiva IE. Most of the patients presented with a subacute course, with prolonged fever or atypical symptoms. Eight patients had embolic complications at presentation. All nine children were treated with combination antimicrobial therapy and six of them received surgical intervention. All patients recovered well without relapse.A. defectiva should be considered in children with infective endocarditis, especially in those with atypical presentations. As complications are frequent and more than half of the ...
Source: Infection - Category: Infectious Diseases Source Type: research
PET CT in endocarditis – Cardiology MCQ – Cardiology MCQ MCQ Radioactive tracer used for detection of active foci of inflammation/metabolism in infective endocarditis is – Correct answer: 4. Fluorine-18 fluorodeoxyglucose Supplementing Dukes criteria with 18F-FDG PET CT increased the sensitivity from 52% to 91% with a slight fall in specificity from 95% to 89%. The authors further noted that reclassification from possible endocarditis to either definite or rejected category could be done in 95% which has great clinical significance [1]. This would permit early initiation of antibiotic therapy in defi...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
PET CT in endocarditis – Cardiology MCQ – Answer Radioactive tracer used for detection of active foci of inflammation/metabolism in infective endocarditis is – Correct answer: 4. Fluorine-18 fluorodeoxyglucose Supplementing Dukes criteria with 18F-FDG PET CT increased the sensitivity from 52% to 91% with a slight fall in specificity from 95% to 89%. The authors further noted that reclassification from possible endocarditis to either definite or rejected category could be done in 95% which has great clinical significance [1]. This would permit early initiation of antibiotic therapy in definite cases w...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Abstract The incidence of infective endocarditis (IE) continues to rise in many populations and is typically accompanied by a shift to healthcare-associated staphylococcal species. Despite efforts with aggressive antibiotic therapy and increasing rates of surgical intervention, little progress has been made to reduce mortality. Disease prevention is therefore a crucial part of limiting its effects. Prevention should target each point in the pathogenic triad of IE; initiating bacteraemia, adhesion to substrate, and proliferation of pathogenic species. Preventative strategies must focus on at-risk patients undergoin...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
Abstract Trans-catheter aortic valve implantation (TAVI) has recently emerged as a less invasive alternative to surgical aortic valve replacement (SAVR) in high risk patients. Although several procedures have been performed worldwide, infective endocarditis (IE) has been reported to be a rare TAVI complication, nevertheless if IE occurs it represents a life-threatening condition and treatment is challenging. TAVI-IE are thus normally treated conservatively by targeted antibiotic therapy with a high reported mortality (40%). Surgical explant represent the definitive strategy but, the intervention is at a high risk ...
Source: Annales de Cardiologie et d'Angeiologie - Category: Cardiology Authors: Tags: Ann Cardiol Angeiol (Paris) Source Type: research
This study evaluated the use of oral anticoagulant and antiplatelet agents on the development of embolic complications and bleeding episodes within 30 days of IE diagnosis. METHODS: This pilot study was a retrospective medical record review of patients receiving treatment for IE between July 1, 2012, and July 31, 2017. The 2 study arms were patients receiving long-term anticoagulant/antiplatelet therapy versus patients not receiving therapy at the time of IE. Patients were eligible for inclusion if they had definite IE per modified Duke criteria and received at least 48 h of antibiotic therapy. The primary and se...
Source: Clinical Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Ther Source Type: research
Authors: Guzek A, Braksator W, Gąsior Z, Kuśmierczyk M, Różański J, Rybicki Z Abstract Infective endocarditis (IE), despite the diagnostic and therapeutic advances, still remains a serious disease associated with high mortality and serious complications. The present guidelines of the European Cardiology Society of 2015 recommend administration of the antibiotics indicated in empirical therapy for multiple weeks and in targeted treatment often for 6-8 weeks. This is associated with a risk of adverse effects of antibiotic therapy in the form of nephro- and/or hepatotoxicity and an increased risk of infections...
Source: Polish Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Kardiochir Torakochirurgia Pol Source Type: research
ConclusionAmong patients with native valve IE who needed cardiac surgery, the time of surgical intervention did not affect the in ‐hospital mortality. However, early surgery was associated with significantly shorter LOS and lower HC.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
1152Objectives: Cardiac implantable electronic devices (CIED) involves Pacemakers, Implantable cardioverter defibrillators, cardiac resynchronization therapy (CRT) devices. With the advances in technology these has been an increase in the utilization of these devices. Infection is an extremely serious complication requiring removal of the infected device. They have an enormous impact on mortality, length of stay and financial burden to the health care system. CIED infections can occur by two pathways, direct contamination of the devices or by hematogenous seeding of the device from a distant source. The pathogens form a bi...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Poster Session I Source Type: research
CONCLUSIONS: This first update confirms the findings of the original version of the review. Limited and low to very low-quality evidence suggests that the comparative effects of different antibiotic regimens in terms of cure rates or other relevant clinical outcomes are uncertain. The conclusions of this updated Cochrane Review were based on few RCTs with a high risk of bias. Accordingly, current evidence does not support or reject any regimen of antibiotic therapy for the treatment of infective endocarditis. PMID: 32407558 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
More News: Antibiotic Therapy | Cardiology | Endocarditis | Health Management | Heart | Infective Endocarditis