Baidu
map

NEJM:注射联合口服抗生素治疗心内膜炎

2018-08-30 zhangfan MedSci原创

研究认为,对于病情稳定的左心感染性心内膜炎患者可以采用口服抗生素疗法代替静脉注射

左心感染性心内膜炎患者通常需接受6周的静脉抗生素治疗。近日研究人员考察了病情稳定患者,从静脉抗生素转为口服抗生素是否会产生类似于持续静脉治疗的疗效和安全性

400名健康状况稳定的因链球菌、粪肠球菌、金黄色葡萄球菌或凝固酶阴性葡萄球菌引起的心脏心内膜炎患者,随机接受静脉抗生素(199例)或口服抗生素(201例)后继治疗。抗生素注射治疗至少持续10天,口服组如果达到指标即可出院。研究的主要终点为原因死亡率、计划外心脏手术、栓塞事件、复发性菌血症或主要病原体心内感染

静脉抗生素组平均治疗周期19天,而口服组平均治疗周期17天。静脉抗生素组24人(12.1%)以及口服组18人(9.0%)发生主要终点事件(组间差异3.1%),达到非劣性终点。

研究认为,对于病情稳定的左心感染性心内膜炎患者可以采用口服抗生素疗法代替静脉注射。

原始出处:

Kasper Iversen et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med.August 30 2018.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1708475, encodeId=1c2d1e084752f, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Wed Apr 17 10:12:00 CST 2019, time=2019-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345232, encodeId=170f134523234, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350711, encodeId=f9131350e1147, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417318, encodeId=bd64141e3183c, content=<a href='/topic/show?id=625a3821ebe' target=_blank style='color:#2F92EE;'>#口服抗生素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38217, encryptionId=625a3821ebe, topicName=口服抗生素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89f83256788, createdName=dinorsor525, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341774, encodeId=f651341e7484, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 30 12:11:07 CST 2018, time=2018-08-30, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1708475, encodeId=1c2d1e084752f, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Wed Apr 17 10:12:00 CST 2019, time=2019-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345232, encodeId=170f134523234, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350711, encodeId=f9131350e1147, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417318, encodeId=bd64141e3183c, content=<a href='/topic/show?id=625a3821ebe' target=_blank style='color:#2F92EE;'>#口服抗生素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38217, encryptionId=625a3821ebe, topicName=口服抗生素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89f83256788, createdName=dinorsor525, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341774, encodeId=f651341e7484, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 30 12:11:07 CST 2018, time=2018-08-30, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1708475, encodeId=1c2d1e084752f, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Wed Apr 17 10:12:00 CST 2019, time=2019-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345232, encodeId=170f134523234, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350711, encodeId=f9131350e1147, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417318, encodeId=bd64141e3183c, content=<a href='/topic/show?id=625a3821ebe' target=_blank style='color:#2F92EE;'>#口服抗生素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38217, encryptionId=625a3821ebe, topicName=口服抗生素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89f83256788, createdName=dinorsor525, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341774, encodeId=f651341e7484, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 30 12:11:07 CST 2018, time=2018-08-30, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1708475, encodeId=1c2d1e084752f, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Wed Apr 17 10:12:00 CST 2019, time=2019-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345232, encodeId=170f134523234, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350711, encodeId=f9131350e1147, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417318, encodeId=bd64141e3183c, content=<a href='/topic/show?id=625a3821ebe' target=_blank style='color:#2F92EE;'>#口服抗生素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38217, encryptionId=625a3821ebe, topicName=口服抗生素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89f83256788, createdName=dinorsor525, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341774, encodeId=f651341e7484, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 30 12:11:07 CST 2018, time=2018-08-30, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1708475, encodeId=1c2d1e084752f, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Wed Apr 17 10:12:00 CST 2019, time=2019-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345232, encodeId=170f134523234, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350711, encodeId=f9131350e1147, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417318, encodeId=bd64141e3183c, content=<a href='/topic/show?id=625a3821ebe' target=_blank style='color:#2F92EE;'>#口服抗生素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38217, encryptionId=625a3821ebe, topicName=口服抗生素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89f83256788, createdName=dinorsor525, createdTime=Sat Sep 01 02:12:00 CST 2018, time=2018-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341774, encodeId=f651341e7484, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 30 12:11:07 CST 2018, time=2018-08-30, status=1, ipAttribution=)]
    2018-08-30 1ddf0692m34(暂无匿称)

    学习了,长知识

    0

相关资讯

Heart:先心病患者有较高的感染性心内膜炎发生率和死亡率

感染性心内膜炎(IE)有较高的发生率和死亡率,成年先天性心脏病(ACHD)患者患IE的风险更高,本研究的目的旨在评估ACHD患者发生感染性心内膜炎的发生率、死亡率和预测结局的相关因素。本研究纳入了1999-2013年诊断为感染性心内膜炎的成年先心病患者,主要终点事件是心内膜炎相关死亡率。最终,共有144名患者发生了164例感染性心内膜炎(男性有102名,占70.8%),平均年龄为32.3±22.7

这么严重的冠脉病变,是怎么造成的?

患者,男,1967年生。2016年因“反复活动后胸闷、胸痛3年”就诊。2013年因感染性心内膜炎在外院行主动脉瓣+二尖瓣置换术,术前未行冠脉造影或CTA,术后规律抗凝,无发热。

Circulation:改善18F-FDG PET/CT对人工心脏瓣膜心内膜炎的诊断性能

FDG PET/CT的视觉和定量评估对疑似PVE患者具有很高的诊断准确性。

JACC:BAV或MVP感染性心内膜炎:到底是否需抗生素预防?

关于二尖瓣主动脉瓣(BAV)或二尖瓣脱垂(MVP)患者感染性心内膜炎(IE)的信息很少。目前,不推荐感染性心内膜炎抗生素预防(IEAP)用于这些病症。2018年6月,发表在《J Am Coll Cardiol》的一项研究描述BAV和MVP患者IE的临床和微生物学特征,并将其与合并或不合并IEAP指征的IE患者进行比较,以确定IEAP在这些疾病中的潜在益处。

JACC:侵入性医疗操作会增加感染性心内膜炎发生风险

许多侵入性医疗操作会引起菌血症,从而导致感染性心内膜炎的发生。本研究的目的旨在量化感染性心内膜炎与侵入性医疗和外科手术相关的过度风险。本研究纳入了1998年至2011年瑞典因感染性心内膜炎住院治疗的7013例患者,采用病例交叉设计,比较心内膜炎发生前12周内患者接受侵入性医疗操作的情况与其1年前相同12周内的操作情况。分析结果显示,许多心血管医疗操作,尤其是冠状动脉旁路移植术、皮肤和伤口处理的操作

周密:从病例看心内膜炎的治疗和预防

心内膜炎是由病原微生物直接侵袭心内膜而引起的一种炎症性疾病,常起病缓慢,症状多样,合理应用抗菌药物是治疗心内膜炎最重要的治疗措施,如何选对药、用对量、达到最佳治疗效果?且听在2017全国感控年会上抗感染临床药师周密老师通过一份真实病例从临床药师的角度分析心内膜炎的治疗和预防。

Baidu
map
Baidu
map
Baidu
map