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- W4313443921 abstract "Infective endocarditis is one of the most difficult-to-treat infectious diseases. Selection of medical therapy for patients with blood culture negative infective endocarditis (BCNIE) is difficult; therefore, patients with BCNIE are often treated empirically for the more common bacterial causes of IE during the waiting time. We performed this study to evaluate the efficacy of our empirical treatment of BCNE. We retrospectively collected cases of BCNIE seen in a tertiary hospital, between 2014 and 2021. Demographic data, clinical data, biological data, treatment and outcome were collected. The choice of empirical treatment aimed to cover the most common pathogens. We applied different kinds of protocols to treat BCNIE, which include the following intravenous antimicrobial agents: ceftriaxone, ceftazidime, and gentamicin. During our study period, 83 patients with definite BCNIE were admitted: 62.65% received an antibiotic therapy based on ceftriaxone with gentamicin (group 1), 32.53% were treated with ceftriaxone alone (group 2) while 1.2% were treated with Ceftazidime and Gentamicin (group 3), we switched Ceftriaxone and gentamicin for vancomycin and gentamicin in 3 cases and for imipenem and amikacin in 2 cases because of a poor clinical and persistence of ultrasound images. Our fatality rate was 14,45% (12 cases), six of the deaths were attributed to our empirical treatment failure, Concerning the other deaths: 3 deaths were undetermined, 2 caused by a heart failure and one because of hyperkaliemia; ten of these deaths occurred in the group number 1. During the follow-up of the 3 groups, apyrexia was reported after 4 days of treatment in 63.4% of patients in group 1, 37% of patients in group 2 and 53.3% of patients in group 3. There were also fewer complications in group 1 with 1 embolic event and 7 chordae ruptures, compared to group 2 with 5 embolic events and 9 chordae ruptures. No complications were reported in group 3. Community-acquired BCNIE treated with Ceftriaxone and gentamicin were associated with a significantly lower fatality rate than community-acquired BCNE treated with ceftriaxone alone or with ceftazidime/Gentamicin (P = 0.53)." @default.
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- W4313443921 date "2023-01-01" @default.
- W4313443921 modified "2023-09-26" @default.
- W4313443921 title "Empiric treatement choice in blood culture negative infective endocarditis: A retrospective study" @default.
- W4313443921 doi "https://doi.org/10.1016/j.acvdsp.2022.10.324" @default.
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