A six-week antibiotic treatment of endocarditis with spondylodiscitis is not associated with increased risk of relapse: A retrospective cohort study - 28/04/21
, M. Soubrier b, J. Prouteau c, N. Mrozek c, O. Lesens c, A. Tournadre b, E. Gadea a, M. Vidal cBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 7 |
| Iconographies | 1 |
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Highlights |
• | Spondylodiscitis and endocarditis are often associated. |
• | A 6-week antibiotic treatment occasions little recurrence (<10%). |
• | Associated endocarditis does not seem to increase the risk of recurrence. |
• | Six-week antibiotherapy is well-tolerated. |
Abstract |
Background |
We compared the relapse rate at 1 year in patients with vertebral osteomyelitis with or without associated endocarditis.
Patients and methods |
We conducted a retrospective cohort study. Inclusion criteria were patients hospitalized in the infectious disease, rheumatology, cardiology, cardiovascular surgery and two internal medicine units for vertebral osteomyelitis (blood culture and/or disco-vertebral biopsy) and compatible imaging, between 2014 and 2017. We compared patients with associated endocarditis (VO-EI group) and without endocarditis (VO group) using logistic regression to determine the factors associated with relapse and EI. The main outcome was the relapse rate at 1 year.
Results |
Out of the 207 eligible patients, 62 were included (35 in the VO group and 27 in the VO-EI group). Four patients presented with a new VO during follow-up, one (2.86%) patient in VO group and three (11.11%) in VO-EI group (P=0.68). There were more men in the VO-EI group than in the VO group (74.07% vs. 48.57%, P=0.04), valvulopathies (13/27 vs. 8/35, P=0.06), vertebral localization (1.22±0.50 vs. 1.03±0.17, P=0.04) and septic kidney embolism (5/27 vs. 0/35, P=0.01). Control blood cultures were more often positive in the VO-EI group (12/27 vs. 8/35, P=0.04). In 45% of patients, the germ was a staphylococcus, 29% streptococci, 10% enterococci, 10% gram-negative bacillus (GNB). There were more streptococci and enterococci in the VO-EI group than in the VO group (44.44% vs. 17.14% and 18.52% vs. 8.57%, respectively). Antibiotic safety was good and comparable between groups.
Conclusion |
In a relatively small population, we did not find significantly more relapse in the endocarditis group.
Le texte complet de cet article est disponible en PDF.Keywords : Osteomyelitis, Endocarditis, Antibiotics
Plan
Vol 51 - N° 3
P. 253-259 - mai 2021 Retour au numéro
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