Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone
Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone
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DOI：
10.1111/1469-0691.12756
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发表时间：
2014-12-01
影响因子：
14.2
通讯作者：
Miro, J. M.
中科院分区：
文献类型：
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作者：
Pericas, J. M.;Cervera, C.;Miro, J. M.
本研究的目的是评估粪肠球菌感染性心内膜炎（EFIE）患者的抗生素耐药性、流行病学和结局的变化，并比较氨苄西林和庆大霉素（A+G）与氨苄西林+头孢曲松（A+C）的疗效和安全性。该研究是对1997年至2011年在我们中心接受治疗的EFIE患者前瞻性队列的回顾性分析。其中30例先用A+G（氨苄青霉素2g/4 h+庆大霉素3 mg/kg/d），39例先用A+C（氨苄青霉素2g/4 h+头孢曲松2g/12 h），疗程4- 6周。近年来观察到高水平氨基糖苷类耐药率（HLAR;庆大霉素MIC 512 mg/L，链霉素MIC 1024 mg/L或两者）增加（1997-2006年为24%，2007-2011年为49%; p 0.03）。A+C的使用随着时间的推移而增加：1997-2001年，4/18（22%）; 2002-2006年，5/16（31%）; 2007-2011年，30/35（86%）（p
The aim of this study was to assess changes in antibiotic resistance, epidemiology and outcome among patients with Enterococcus faecalis infective endocarditis (EFIE) and to compare the efficacy and safety of the combination of ampicillin and gentamicin (A+G) with that of ampicillin plus ceftriaxone (A+C). The study was a retrospective analysis of a prospective cohort of EFIE patients treated in our centre from 1997 to 2011. Thirty patients were initially treated with A+G (ampicillin 2g/4h and gentamicin 3mg/kg/day) and 39 with A+C (ampicillin 2g/4h and ceftriaxone 2g/12h) for 4-6weeks. Increased rates of high-level aminoglycoside resistance (HLAR; gentamicin MIC 512mg/L, streptomycin MIC 1024mg/L or both) were observed in recent years (24% in 1997-2006 and 49% in 2007-2011; p0.03). The use of A+C increased over time: 1997-2001, 4/18 (22%); 2002-2006, 5/16 (31%); 2007-2011, 30/35 (86%) (p