Antibiotherapy strategy established by infectious disease specialist wisdom determine an excellent outcome in prosthetic valve endocarditis patients

Introduction: Empirical antibiotherapy for prosthetic valve endocarditis (PVE) is usually established accordingly to practice guideline that recommends only one association irrespective of the patient particularities.
Objective: To determine how different antibiotherapy (AT) strategies established by infectious diseases speci-alists could influence PVE outcome.
Methods: Retrospective analysis of 56 patients, aged 54.64±11.34 years, men 64%, diagnosed with PVE, di-vided in early PVE (29) and late PVE (27). We evaluated their outcome with the antibiotic treatment established by infectious disease specialist. Analyzed variables: de-mographic data, comorbidities, etiology (>50% negati-ve cultures), clinical, biological and echocardiographic parameters, outcome.
Results: Antibiotic therapy established by infectious diseases specialist generated the cure of de disease in 71% cases with an in-hospital death rate of 2% and a rate of early surgery of 21.4%. Combined therapy (me-dical and surgical) determines an excellent outcome in 90.4% patients at the end of antibiotic cure. The positi-ve outcome does not depend on the type of antibiotic selection (multivariate analysis). Moreover AT suffer frequent changes due to side effects, escecially cutaneo-us and renal with Oxacilline (p=0.035) or Vancomycin (p=0.005). Imipenem+Amikacin, when combined, de-termines less adverse effects, a shorter time to fever di-sappearance (p=.004).
Conclusions: Antibiotic therapy, when individualized by an infectious disease specialist determine a good outcome, irrespective of antibioc combination, irre-spective of PVE type and irrespective of disease etio-logy, including in negative culture valve endocarditis. Infectious disease specialist is the cornerstone in the endocarditis team.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)