Infective Endocarditis
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Findings in heart disease reported from Lewis University
2009 JUN 29 - (NewsRx.com) -- "Infective endocarditis (IE) is the fourth leading cause of life-threatening infection in the United States and imposes significant morbidity and mortality. The American Heart Association guidelines for the diagnosis and treatment of IE do not address continuous-infusion (CI) oxacillin," investigators in the United States report. "This retrospective study compares outcomes between CI oxacillin and intermittent-infusion (II) oxacillin in the treatment of IE caused by methicillin-susceptible Staphylococcus aureus (MSSA). A total of 709 medical records were reviewed for inpatients with definitive IE treated between 1 January 2000 and 31 December 2007. Continuous data were analyzed by Student's t test or the Wilcoxon rank sum test. The chi-square test or Fisher's exact test was used to compare nominal data. A multivariate logistic model was constructed. One hundred seven patients met eligibility criteria for inclusion into the study. Seventy-eight patients received CI oxacillin, whereas 28 received II oxacillin. CI and II groups were similar with respect to 30-day mortality (8% versus 10%, P = 0.7) and length of stay (20 versus 25 days, P = 0.4) but differed in 30-day microbiological cure (94% versus 79%, P = 0.03). Sixty-three patients received synergistic gentamicin, whereas 44 did not. The gentamicin and no-gentamicin groups were similar with respect to 30-day mortality (11% versus 4%, P = 0.2) and 30-day microbiological cure (90% versus 89%, P = 0.8); however, times to defervescence (4 versus 2 days, P = 0.02) were significantly different. CI oxacillin is an effective alternative to II oxacillin for the treatment of IE caused by MSSA and may improve microbiological cure," wrote D.W. Hughes and colleagues, Lewis University. The researchers concluded: "This convenient and pharmacodynamically optimized dosing regimen for oxacillin deserves consideration for patients with IE caused by MSSA." Hughes and colleagues published their study in Antimicrobial Agents and Chemotherapy (Continuous versus Intermittent Infusion of Oxacillin for Treatment of Infective Endocarditis Caused by Methicillin-Susceptible Staphylococcus aureus. Antimicrobial Agents and Chemotherapy, 2009;53(5):2014-2019). For additional information, contact J.S. Lewis, University of Health Systems, Dept. of Pharmacy Service, 4502 Med Dr., San Antonio, TX 78229, USA. The publisher of the journal Antimicrobial Agents and Chemotherapy can be contacted at: American Society Microbiology, 1752 N St. NW, Washington, DC 20036-2904, USA. Keywords: United States, San Antonio, Anti-Infectives, Antimicrobials, Cardiology, Chemotherapy, Clinical Trials, Coronary Artery Disease, Drug Therapy, Endocarditis, Heart Disease, Infective Endocarditis, Oxacillin, Post-Trials Research, Lewis University. This article was prepared by Anti-Infectives Week editors from staff and other reports. Copyright 2009, Anti-Infectives Week via NewsRx.com.
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