Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. A More COMPLETE Picture of Revascularization in STEMI

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Partial Oral Therapy for Osteomyelitis and Endocarditis. Reply

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Effects of Serelaxin in Patients with Acute Heart Failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Ibrutinib and Venetoclax for First-Line Treatment of CLL

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Prevalence and risk factors of prolonged QT interval and electrocardiographic abnormalities in persons living with HIV

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Aetiologies and temporal trends of atrioventricular block in young patients: a 20-year nationwide study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Association between Type D personality and outcomes in patients with non-ischemic heart failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND Patients with infective endocarditis on the left side of the heart are typically treated with intravenous antibiotic agents for up to 6 weeks. Whether a shift from intravenous to oral antibiotics once the patient is in stable condition would result in efficacy and safety similar to those with continued intravenous treatment is unknown. METHODS In a randomized, noninferiority, multicenter trial, we assigned 400 adults in stable condition who had endocarditis on the left side of the heart caused by streptococcus, Enterococcus faecalis, Staphylococcus aureus, or coagulase-negative staphylococci and who were being treated with intravenous antibiotics to continue intravenous treatment (199 patients) or to switch to oral antibiotic treatment (201 patients). In all patients, antibiotic treatment was administered intravenously for at least 10 days. If feasible, patients in the orally treated group were discharged to outpatient treatment. The primary outcome was a composite of all-cause mortality, unplanned cardiac surgery, embolic events, or relapse of bacteremia with the primary pathogen, from the time of randomization until 6 months after antibiotic treatment was completed. RESULTS After randomization, antibiotic treatment was completed after a median of 19 days (interquartile range, 14 to 25) in the intravenously treated group and 17 days (interquartile range, 14 to 25) in the orally treated group (P=0.48). The primary composite outcome occurred in 24 patients (12.1%) in the intravenously treated group and in 18 (9.0%) in the orally treated group (between-group difference, 3.1 percentage points; 95% confidence interval, −3.4 to 9.6; P=0.40), which met noninferiority criteria. CONCLUSIONS In patients with endocarditis on the left side of the heart who were in stable condition, changing to oral antibiotic treatment was noninferior to continued intravenous antibiotic treatment.

OriginalsprogEngelsk
TidsskriftThe New England journal of medicine
Vol/bind380
Udgave nummer5
Sider (fra-til)415-424
Antal sider10
ISSN0028-4793
DOI
StatusUdgivet - 31 jan. 2019

ID: 55417028