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Prospective evaluation of a two-week course of intravenous antibiotics in intravenous drug addicts with infective endocarditis

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Abstract

In a prospective study, a two-week course of antibiotics (cloxacillin 2 g/4 h plus amikacin 7.5 mg/kg/12 h) was evaluated in the therapy of right-sided infective endocarditis in intravenous drug users (IVDU). All IVDU admitted to hospital during the study period who fulfilled the strict criteria for diagnosis of infective endocarditis were analysed. A subgroup of patients with right-sided endocarditis caused byStaphylococcus aureus who had a good prognosis were selected as being eligible for the two-week course of treatment. In a total of 139 episodes of infective endocarditis in IVDU, 72 (51.8 %) cases were eligible for the two-week treatment. Of this group, 67 were cured, 4 needed prolongation of treatment to cure the infection and 1 died in hospital of respiratory distress syndrome on day 10 of treatment. In patients not eligible for the two-week treatment, the mortality was higher (24.2 % versus 0.7 %; p=0.00015). Drug toxicity in the treated group was low. It can be concluded that administration of cloxacillin and amikacin parenterally for 14 consecutive days was successful in the therapy of right-sided endocarditis in IVDU.

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Author information

Authors and Affiliations

  1. Infectious Diseases Unit, Hospital Punta de Europa, Algeciras (Cádiz), Spain

    M. Torres-Tortosa

  2. Clinical Microbiology Unit, Hospital Punta de Europa, Algeciras (Cádiz), Spain

    M. de Cueto

  3. Infectious Diseases Unit, Hospital Universitario, Puerto Real (Cádiz), Spain

    A. Vergara

  4. Clinical Microbiology Unit, Hospital del SAS, La Línea de la Concepción (Cádiz), Spain

    A. Sánchez-Porto

  5. Internal Medicine Service, Hospital del SAS, La Línea de la Concepción (Cádiz), Spain

    M. González-Serrano

  6. Infectious Diseases Unit, Hospital Universitario, Puerta del Mar, Cádiz, Spain

    E. Pérez-Guzmán & J. Canueto

Authors
  1. M. Torres-Tortosa
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  2. M. de Cueto
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  3. A. Vergara
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  4. A. Sánchez-Porto
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  5. E. Pérez-Guzmán
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  6. M. González-Serrano
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  7. J. Canueto
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Grupo de Estudio de Enfermedades Infecciosas de la provincia de Cádiz

Additional information

E. Cruz, Hospital Universitario, Puerto Real; S. Pérez-Cortés, Hospital del SAS, Jerez de la Frontera; J. Pérez-Jiménez, Clínica San Rafael, Cádiz; F. López-Rincón, Hospital Punta de Europa, Algeciras, Spain.

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Torres-Tortosa, M., de Cueto, M., Vergara, A. et al. Prospective evaluation of a two-week course of intravenous antibiotics in intravenous drug addicts with infective endocarditis. Eur. J. Clin. Microbiol. Infect. Dis. 13, 559–564 (1994). https://doi.org/10.1007/BF01971306

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