Over 870 days of successful antibiotic suppression therapy for VRE‐infected left ventricular assist device

Radcliffe, Christopher; Grant, Matthew

doi:10.1111/jocs.14690

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…The avascularity, lowered pH and redox potential of these infective loci oftentimes impede access and bactericidal activity of extraneous antibiotics in addition to components of the immune system [ 3 , 4 ]. Foreign bodies, including indwelling prostheses, are also frequently involved in deep-seated infections, for the same reasons [ 5 , 6 ]. These infections typically involve a large inoculum of organisms many of which may be metabolically dormant and/or incorporated within protective biofilm, rendering them less vulnerable to destruction by antibiotics and the host immune response [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Experience with dalbavancin use in various gram-positive infections within Aberdeen Royal Infirmary OPAT service

McSorley,

Reyes,

Tonna

et al. 2024

Infection

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Purpose Dalbavancin, approved in 2014 for Gram-positive acute bacterial skin and skin structure infections (ABSSSI), has pharmacokinetics enabling treatment with one or two doses. Dalbavancin might be useful in outpatient parenteral antibiotic therapy (OPAT) of deep-seated infections, otherwise requiring inpatient admission. We documented our experience with pragmatic dalbavancin use to assess its effectiveness for varied indications, on- and off-label, as primary or sequential consolidation therapy. Methods Patients prescribed dalbavancin between 1 December 2021 and 1 October 2022 were screened for demographics of age, sex, Charlson comorbidity index (CCI), allergies, pathogens, doses of dalbavancin, other antibiotics administered and surgery. Where available, infection markers were recorded. The primary outcome was a cure at the end of treatment. Secondary outcomes included any adverse events and for those with treatment failures, response to salvage antibiotics. Results Sixty-seven per cent of patients were cured. Cure rates by indication were 93% for ABSSSI, 100% for bacteraemia, 90% for acute osteomyelitis, 0% for chronic osteomyelitis, 75% for native joint septic arthritis and 33% for prosthetic joint infection. Most bone and joint infections that were not cured did not have source control, and the goal of treatment was suppressive. Successful suppression rates were greater at 48% for chronic osteomyelitis and 66% for prosthetic joint infections. Adverse events occurred in 14 of 102 patients. Conclusion This report adds to clinical experience with dalbavancin for off-label indications whilst further validating its role in ABSSSI. Dalbavancin as primary therapy in deep-seated infections merits investigation in formal clinical trials.

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Section: Introductionmentioning

confidence: 99%

Experience with dalbavancin use in various gram-positive infections within Aberdeen Royal Infirmary OPAT service

McSorley,

Reyes,

Tonna

et al. 2024

Infection

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The Use of Long-term Antibiotics for Suppression of Bacterial Infections

Horne,

Woolley,

Lau

2024

Clinical Infectious Diseases

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Suppressive antibiotic therapy is prescribed when a patient has an infection that is presumed to be incurable by a defined course of therapy or source control. The cohort receiving suppressive antibiotic therapy is typically highly comorbid and the infections often involve retained prosthetic material. In part due to a lack of clear guidelines regarding the use of suppressive antibiotics, and in part due to the complex nature of the infections in question, patients are often prescribed suppressive antibiotics for extremely long, if not indefinite, courses. The risks of prolonged antibiotic exposure in this context are not fully characterised, but they include adverse drug effects ranging from mild to severe, the development of antibiotic resistant organisms and perturbations of the gastrointestinal microbiome. In this narrative review we present the available evidence for the use of suppressive antibiotic therapy in four common indications, examine the gaps in the current literature and explore the known and potential risks of this therapy. We also make suggestions for improving the quality of evidence in future studies, particularly by highlighting the need for a standardised term to describe the use of long-courses of antibiotics to suppress hard-to-treat infections.

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Left ventricular assist device exchange from HeartMate II to HeartMate 3 in an Asian patient—a case report and literature review

Chang

Kuo

Chen

et al. 2023

J Cardiothorac Surg

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Background Pump exchange surgery of left ventricular assist device (LVAD) has been demonstrated in several studies; however, information for Asian patients was limited. Case presentation A 63-year-old man underwent a pump upgrade from HeartMate II to HeartMate 3 for driveline damage through limited left anterior thoracotomy and lower partial sternotomy. He did not experience any hemodynamic adverse events or device malfunction during postoperative follow-ups of 12 months. We also reviewed all published cases with HeartMate II exchange to HeartMate 3. Conclusions The case demonstrated that it was safe and feasible to perform HMII LVAD exchange to HM3 through a limited approach for Asian patients.

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Over 870 days of successful antibiotic suppression therapy for VRE‐infected left ventricular assist device

Cited by 3 publications

References 11 publications

Experience with dalbavancin use in various gram-positive infections within Aberdeen Royal Infirmary OPAT service

Experience with dalbavancin use in various gram-positive infections within Aberdeen Royal Infirmary OPAT service

The Use of Long-term Antibiotics for Suppression of Bacterial Infections

Left ventricular assist device exchange from HeartMate II to HeartMate 3 in an Asian patient—a case report and literature review

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