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Title

Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

AuthorsGarcía-Álvarez, Lara; Sanz, Mercedes; Marín-Arriaza, Mercedes; Fariñas, María del Carmen; Montejo, Miguel; Goikoetxea, Josune; Rodríguez-García, Raquel; Alarcón González, Arístides de; Almela, Manel; Fernández-Hidalgo, N.; Alonso Socas, M. Mar; Goenaga Sánchez, Miguel Ángel; Navas, Enrique; Vicioso, Luis; Oteo, José Antonio
Issue DateJun-2019
PublisherOxford University Press
CitationJournal of Antimicrobial Chemotherapy 74(6): 1713–1717 (2019)
Abstract[Objectives] Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei.
[Patients and methods] Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options.
[Results] Follow-up data were obtained from 14 patients. The median follow-up was 46.5 months. All patients completed the antibiotic treatment prescribed, with a median duration of 13 months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13 months), four with doxycycline + hydroxychloroquine (median duration 13.8 months) and four with other treatment options (median duration 22.3 months). The follow-up after the end of the treatments was between 5 and 84 months (median 24 months).
[Conclusions] All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.
DescriptionSpanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES)
Publisher version (URL)https://doi.org/10.1093/jac/dkz059
URIhttp://hdl.handle.net/10261/212899
DOI10.1093/jac/dkz059
ISSN0305-7453
E-ISSN1460-2091
ReferencesGarcía-Álvarez, Lara; Sanz, Mercedes; Marín-Arriaza, Mercedes; Fariñas, María del Carmen; Montejo, Miguel; Goikoetxea, Josune; Rodríguez-García, Raquel; Alarcón González, Arístides de; Almela, Manel; Fernández-Hidalgo, N.; Alonso Socas, M. Mar; Goenaga Sánchez, Miguel Ángel; Navas, Enrique; Vicioso, Luis; Oteo, José Antonio. Correction: Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience. https://doi.org/10.1093/jac/dkz111 . http://hdl.handle.net/10261/212901
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