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

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

doi:10.1016/j.jiac.2018.03.003

Cited by 24 publications

(13 citation statements)

References 40 publications

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“…Even though both AHA and ESC guidelines recommend initial triple therapy, which includes rifampin and an aminoglycoside, for staphylococcal PVE [ 2 , 3 ], 34% of respondents did not use an aminoglycoside in that setting. Based on those results, it might be concluded that aminoglycoside therapy for staphylococcal PVE is perhaps “falling out of favor.” A recent retrospective study from Spain [ 17 ] and a narrative review from France [ 18 ] both suggested that aminoglycoside use in staphylococcal PVE may not be necessary. In contrast to the tepid embrace of aminoglycosides for staphylococcal PVE, 91% of those surveyed reported using rifampin.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Infective Endocarditis Guidelines: The Challenges of Adherence—A Survey of Infectious Diseases Clinicians

Huang

Gupta

Davis

et al. 2020

Open Forum Infectious Diseases

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Background Guidelines exist to aid clinicians in managing patients with infective endocarditis (IE), but the degree of adherence with guidelines by infectious disease (ID) physicians is largely unknown. Methods An electronic survey assessing adherence with selected IE guidelines was emailed to 1409 adult ID physician members of the Infectious Diseases Society of America’s Emerging Infections Network. Results Five hundred fifty-seven physicians who managed IE responded. Twenty percent indicated that ID was NOT consulted on every case of IE at their hospitals, and 13% did not recommend transthoracic echocardiography (TTE) for all IE cases. The duration of antimicrobial therapy was timed from the first day of negative blood cultures by 91% of respondents. Thirty-four percent of clinicians did not utilize an aminoglycoside for staphylococcal prosthetic valve IE (PVE). Double β-lactam therapy was “usually” or “almost always” employed by 83% of respondents for enterococcal IE. For patients with active IE who underwent valve replacement and manifested positive surgical cultures, 6 weeks of postoperative antibiotics was recommended by 86% of clinicians. Conclusions The finding that adherence was &90% with core guideline recommendations that all patients with suspected IE be seen by ID and that all patients undergo TTE is noteworthy. Aminoglycoside therapy of IE appears to be declining with double β-lactam regimens emerging as the preferred treatment for enterococcal IE. The duration of postoperative antimicrobial therapy for patients undergoing valve replacement during acute IE is poorly defined and represents an area for which additional evidence is needed.

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Section: Discussionmentioning

confidence: 99%

“…In contrast to the tepid embrace of aminoglycosides for staphylococcal PVE, 91% of those surveyed reported using rifampin. Both Ramos-Martinez et al [ 17 ] and Lebeaux and colleagues [ 18 ] endorsed rifampin as the critical component of combination therapy for staphylococcal PVE.…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis Guidelines: The Challenges of Adherence—A Survey of Infectious Diseases Clinicians

Huang

Gupta

Davis

et al. 2020

Open Forum Infectious Diseases

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“…One study (n = 46) addressed the comparison of treatment groups 1–4 [ 24 ]. Two studies (n = 23 and n = 94) evaluated a comparison of treatment group 2 to 3 [ 26 , 27 ]. One study (n = 180) compared treatment group 1 to 3 [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis

Ryder

Tong

Gallagher

et al. 2022

Open Forum Infectious Diseases

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Background Based primarily on in vitro and animal models, with little data directly addressing patient outcomes, current guidelines recommend treating staphylococcal prosthetic valve endocarditis (PVE) with antibiotic combinations including gentamicin and rifampin. Here, we synthesize the clinical data on adjunctive rifampin and gentamicin in staphylococcal PVE. Methods We conducted a systematic review and meta-analysis of PubMed- and Cochrane-indexed studies reporting outcomes of staphylococcal PVE treated with adjunctive rifampin, gentamicin, both agents, or neither (i.e., glycopeptide or beta-lactam monotherapy). We recorded outcomes including mortality, relapsed infection, length of stay, nephrotoxicity, hepatotoxicity, and important drug-drug interactions (DDIs). Results Four relevant studies were identified. Two studies (n = 117) suggested adding gentamicin to rifampin-containing regimens did not reduce clinical failure (OR 0.98; 95% CI 0.39-2.46), and two studies (n = 201) suggested adding rifampin to gentamicin-containing regimens did not reduce clinical failure (OR 1.29; 95% CI 0.71-2.33). Neither gentamicin nor rifampin was associated with reduced infection relapse; one study found rifampin treatment associated with longer hospitalizations (mean 31.3 vs 42.3 days, p < 0.001). Comparative safety outcomes were rarely reported, but one study found rifampin associated with hepatoxicity, nephrotoxicity, and DDIs, leading to treatment discontinuation in 31% of patients. Conclusion The existing clinical data do not suggest a benefit of either adjunctive gentamicin or rifampin in staphylococcal PVE. Given other studies also suggest these agents add nephrotoxicity, hepatoxicity, and risk DDIs without benefit in staphylococcal endovascular infections, we suggest recommendations for gentamicin and rifampin in PVE be downgraded and they primarily be used within the context of clinical trials.

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“…[3,4] Some of the current recommendations include aminoglycosides in the treatment of SAPVE, [35] although there is some evidence indicating the absence of benefit of its addition even in the presence of prosthetic material. [54] The use of aminoglycosides was less frequent in patients treated with daptomycin, probably because the presence of renal failure was more frequent in this group, or because new synergistic combinations were used.…”

Section: Discussionmentioning

confidence: 99%

“A contemporary description of staphylococcus aureus prosthetic valve endocarditis. Differences according to the time elapsed from surgery”

et al. 2019

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Staphylococcus aureus prosthetic valve endocarditis (SAPVE) has a poor prognosis. There are no large series that accurately describe this entity.This is a retrospective observational study on a prospective cohort from 3 Spanish reference hospitals for cardiac surgery, including 78 definitive episodes of left SAPVE between 1996 and 2016.Fifty percent had a Charlson Index score >5; 53% were health care-related. Twenty percent did not present fever. Complications at diagnosis included: severe heart failure (HF, 29%), septic shock (SS, 17.9%), central nervous system abnormalities (19%), septic metastasis (4%). Hemorrhagic stroke was not higher in anticoagulated patients. Twenty-seven percent were methicilin-resistant SA (MRSA). Fifteen of 31 had positive valve culture; it was related to surgery within first 24 hours. At diagnosis, 69% had vegetation (>10 mm in 75%), 21.8% perianular extension, and 20% prosthetic dehiscence. Forty-eight percent had persistent bacteremia, related to nonsurgical treatment. Perianular extension progressed in 18%. Surgery was performed in 35 episodes (12 with stroke). Eleven uncomplicated episodes were managed with medical therapy, 8 survived. In-hospital mortality was 55%, higher in episodes with hemorrhagic stroke (77.8% vs 52.2%, odds ratio 3.2 [0.62–16.55]). Early SAPVE was nosocomial (92%), presented as severe HF (54%), patients were diagnosed and operated on early, 38% died. In intermediate SAPVE (9 weeks–1 year) diagnosis was delayed (24%), patients presented with constitutional syndrome (18%), renal failure (41%), and underwent surgery >72 hours after indication; 53% died. Late SAPVE (>1 year) was related with health care, diagnosis delay, and 60% of deceases.Left SAPVE frequently affected patients with comorbidity and health care contact. Complications at diagnosis and absence of fever were frequent. Presence of MRSA was high. Positive valve culture was related to early surgery. Paravalvular extension was frequent; vegetations were large, but its absence at diagnosis was common. Some uncomplicated SAPVE episodes were safety treated with medical therapy. Surgery was feasible in patients with stroke. Mortality was high. There were differences in some clinical characteristics and in evolution according to the time elapsed from valve replacement. Prognosis was better in early SAPVE.

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

Cited by 24 publications

References 40 publications

Infective Endocarditis Guidelines: The Challenges of Adherence—A Survey of Infectious Diseases Clinicians

Infective Endocarditis Guidelines: The Challenges of Adherence—A Survey of Infectious Diseases Clinicians

Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis

“A contemporary description of staphylococcus aureus prosthetic valve endocarditis. Differences according to the time elapsed from surgery”

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