Linezolid in infective endocarditis itseems to work
Abstract number: P2007
Lauridsen T.K., Bruun L.E., Rasmussen R.V., Moser C., Johansen H.K., Arpi M., Hassager C., Bruun N.E.
Background: The increasing number of resistant bacterial strains in infective endocarditis (IE) emphasizes the need for a constant development of new antimicrobials. Linezolid is a new antibiotic with effect on Gram-positive cocci. Only few casuistic reports describe its utilization in treatment of IE.
The objective of this study is to report our experience with linezolid from a large contemporary cohort of IE patients.
Methods: In a prospective cohort study data from 521 consecutive patients were collected at two tertiary University Hospitals in Copenhagen, Denmark. Only patients with culture negative IE or IE due to Gram-positive micro organisms were included in the study. Main endpoints were in-hospital and post-discharge mortality in IE patients receiving linezolid for a part of their treatment period vs. non-linezolid treatment.
Results: 521 patients were enrolled in the study, 39 patients received linezolid treatment, and 482 received non-linezolid treatment. Reasons for changing to linezolid were allergic reactions (N = 10), nephrotoxicity (N = 2) and inadequate response to given treatment (N = 17). There were no significant differences in age, gender or co-morbidity such as diabetes, kidney dysfunction, heart failure, cardiac surgery or neurological diseases. There were no differences in the infected valve location or complications to IE such as pseudoaneurysms or intracardiac abscesses. Median duration of linezolid treatment was 18 days (range 269 days). No differences in in-hospital mortality (10% vs. 14%, NS) or post-discharge mortality at 12 months follow-up (26% vs. 27%, NS) linezolid vs. no linezolid, respectively were observed. Only few side effects of linezolid were noted. During linezolid therapy >28 days, 4 of 9 patients developed drug related anemia, requiring blood transfusions.
Conclusion: No difference was found between in-hospital and post-discharge mortality in IE patients receiving linezolid for a part of their treatment period vs. patients with conventional treatment. Despite our results, controlled studies are warranted before linezolid more generally can be recommended for treatment in IE.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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