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.

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