#71 – This is a Potential Breakup Song: Controversies in the Management of Infective Endocarditis
Breakpoints
Refampen for Staph Forase Bacteria
When the patients that received any combination of beta lactam or vancomycin with or without amineglicoside and with or without Refampen were compared to those that only got monotherapy, the combination groups were about six times more likely to be culture negative. But this study did not have any patient related outcomes that were reported,. nothing about treatment related adverse events or even if the patient's lived or died. And so given its retrospective nature, I suspect that there's numerable uncontrolled confounders in the study which makes it difficult to extrapolate into clinical care.
Episode Notes
Episode Notes
Inspired by lamentations on Twitter, Drs. Bobbi Jo Stoner (@BobbiJo_Stoner), Jonathan Ryder (@JonathanRyderMD) and Sami El-Dalati join Dr. Jillian Hayes (@thejillianhayes) to hash out some of the controversies we encounter while managing infective endocarditis. Do we really need gentamicin and rifampin for all cases of staphylococcal prosthetic valve endocarditis? Where do oral antimicrobials fit into this disease state? Who should have a seat at the table to provide the most comprehensive care to these patients? Tune in for the answers to these questions and more!
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References: IDSA/AHA Infective Endocarditis Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000296 Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis: https://pubmed.ncbi.nlm.nih.gov/36408468/ Twitter Poll – Gabe Vilchez (March 2021): https://twitter.com/IdVilchez/status/1372148761112240131?s=20&t=fYuyNWGmzZACWrpUb7Fp3g Survey of ID Physicians on Gent and Rifampin Use: https://pubmed.ncbi.nlm.nih.gov/32964063/ Bacteriological outcome of combination versus single-agent treatment for staphylococcal endocarditis: https://academic.oup.com/jac/article/52/5/820/760105 Treatment of experimental foreign body infection caused by methicillin-resistant Staphylococcus aureus: https://journals.asm.org/doi/abs/10.1128/AAC.34.12.2312 Successful therapy of experimental chronic foreign-body infection due to methicillin-resistant Staphylococcus aureus by antimicrobial combinations: https://journals.asm.org/doi/abs/10.1128/aac.35.12.2611 Rifampin Combination Therapy for Nonmycobacterial Infections: https://journals.asm.org/doi/10.1128/CMR.00034-09 ARREST Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32456-X/fulltext Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study: https://pubmed.ncbi.nlm.nih.gov/32706879/ Nephrotoxicity of vancomycin, alone and with an aminoglycoside: https://pubmed.ncbi.nlm.nih.gov/2351627/ Clinical Data on Daptomycin plus Ceftaroline versus Standard of Care Monotherapy in the Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia: https://journals.asm.org/doi/10.1128/AAC.02483-18 Multicenter Cohort of Patients With Methicillin-Resistant Staphylococcus aureus Bacteremia Receiving Daptomycin Plus Ceftaroline Compared With Other MRSA Treatments: https://academic.oup.com/ofid/article/7/1/ofz538/5691187 CERT Trial (in process): https://clinicaltrials.gov/ct2/show/NCT04886284 Rifampin for Surgically Treated Staphylococcal Infective Endocarditis: A Propensity Score-Adjusted Cohort Study: https://pubmed.ncbi.nlm.nih.gov/26872729/ A step-by-step guide to implementing a multidisciplinary endocarditis team: https://journals.sagepub.com/doi/10.1177/20499361211065596 Management of Infective Endocarditis in People Who Inject Drugs: A Scientific Statement from the American Heart Association: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001090?cookieSet=1 Infectious Complications of Addiction: A Call for a New Subspecialty Within Infectious Diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319263/ A Cross-sectional Analysis of Linezolid in Combination with Methadone or Buprenorphine as a Cause of Serotonin Toxicity: https://academic.oup.com/ofid/article/9/7/ofac331/6625822 POET Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1808312 Risk of New Bloodstream Infections and Mortality Among People Who Inject Drugs With Infective Endocarditis: https://pubmed.ncbi.nlm.nih.gov/32785635/ Comparing right- and left sided injection-drug related infective endocarditis: https://pubmed.ncbi.nlm.nih.gov/33441950/ Evaluation of Partial Oral Antibiotic Treatment for Persons Who Inject Drugs and Are Hospitalized With Invasive Infections: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745005/ Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna: https://pubmed.ncbi.nlm.nih.gov/29659732/ Impact of the duration of antibiotic therapy on relapse and survival following surgery for active infective endocarditis: https://academic.oup.com/ejcts/article/55/4/760/5126415 Bacteriological Outcome after Valve Surgery for Active Infective Endocarditis: Implications for Duration of Treatment after Surgery: https://academic.oup.com/cid/article/41/2/187/529954 Long-term Risk of Hemorrhagic Stroke in Patients With Infective Endocarditis: A Danish Nationwide Cohort Study: https://academic.oup.com/cid/article/68/4/668/5039147 Sign of the Times: Updating Infective Endocarditis Diagnostic Criteria to Recognize Enterococcus faecalis as a Typical Endocarditis Bacterium: https://pubmed.ncbi.nlm.nih.gov/35262664/ Prevalence of colorectal disease in Enterococcus faecalis infective endocarditis: results of an observational multicenter study: https://pubmed.ncbi.nlm.nih.gov/31444092/
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