Naslov
THE EFFECT OF INiTiATION OF ANTIBIOTIC THERAPY ON THE RISK OF EMBOLIZATiON IN INFECTIVE ENDOCARDITIS: AN ANALYSIS FROM THE !CE PROSPECTIVE COHORT STUDY

Autori
Dickerman, Cabell, Abrutyn, Baršić B, Cecchi, de Benito, Eisen, Fortes, Fowler, Miro, Lerakis, Pappas, Rubinstein, Sexton

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
8th International Symposium on Modern Concepts and Cardiovascular Infections, Abstract BookCharleston, SC, USA : / - Charleston (SC), 2005

Skup
8th International Symposium on Modern Concepts and Cardiovascular Infections

Mjesto i datum
Charleston (SC), Sjedinjene Američke Države, 05.2005

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
endocarditis; emboli;
(endocarditis; embolisation; antibiotics)

Sažetak
Background In previous smaller studies, the risk of embolization in infective endocarditis has been demonstrated to fall rapidly with the initiation of appropriate antimicrobial therapy. The purpose of this study was to determine if this finding would be reproduced in a much larger, multicenter international study, and to examine the clinical implications of these findings. Methods 1779 case of definite IE from 39 centers in 16 countries were prospectively enrolled between January 1, 2000 and December 31, 2003. Data were obatined from a standardized case report form. Results In this cohort, 21.4 of patients experienced a clinically apparent embolic phenomenon. Almost half (46.3 or 176/380) of all embolic events occurred at the time of admission. Of all embolic events occurring after admission, 60.3 (123 of 204) occurred during the first three days of antibiotic therapy. Only 4.6 of the total cohort experienced an embolic event after receiving more than three days of effective antimicrobial therapy. Conclusion The risk of embolism in infective endocarditis falls rapidly after the initiation of appropriate antibiotic therapy. For patients in whom the diagnosis of IE is delayed several days after the initiation of antibiotics, as is commonly the case in clinical practice, the risk of embolism is low after diagnosis. This suggests that, as a group, these patients should not undergo surgery based on the risk of embolization alone. Further analysis is needed to a) identify subgroups (e.g., by organism, vegetation size or location) for whom a more aggressive approach may be warranted and b) examine the confounding effect of valvular surgery during index hospitalization on these data.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA