Archives of Internal Medicine · 2003 · 248 citations · 22 references
PharmacyInfectious DiseasesMicrobiologyAntimicrobial PharmacotherapyDiagnostic MicrobiologyMedical MicrobiologyAntimicrobial Agent SelectionBacterial InfectionsDiagnostic BacteriologyEmpiric Antimicrobial TherapyInfective EndocarditisTreatment Of EndocarditisAminoglycoside AntibioticsAntibiotic Regimen OptimizationDuration Of Antimicrobial TreatmentInfectious EndocarditisMicrobiologic DiagnosisPolymerase Chain Reaction (Pcr) AmplificationPolymerase Chain Reaction DetectionRetrospective Case Study
BACKGROUND: Endocarditis caused by Bartonella species is a potentially lethal infection characterized by a subacute evolution and severe valvular lesions. OBJECTIVES: To evaluate the outcome of patients with Bartonella endocarditis and to define the best antibiotic regimen using the following measures: recovery, relapse, or death. METHODS: We performed a retrospective study on 101 patients who were diagnosed in our laboratory as having Bartonella endocarditis between January 1, 1995, and April 30, 2001. Bartonella infection was diagnosed using immunofluorescence with a 1:800 cutoff, polymerase chain reaction amplification of DNA, and/or culture findings of Bartonella species from whole blood, serum, and/or valvular biopsy specimens. A standardized questionnaire was completed by investigators for each patient. RESULTS: Twelve of the 101 patients died and 2 relapsed. Patients receiving an aminoglycoside were more likely to fully recover (P =.02), and those treated with aminoglycosides for at least 14 days were more likely to survive than those with shorter therapy duration (P =.02). CONCLUSION: Effective antibiotic therapy for Bartonella endocarditis should include an aminoglycoside prescribed for a minimum of 2 weeks.
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