Herrera-Hidalgo Laura, Lomas-Cabezas Jose Manuel, López-Cortés Luis Eduardo, Luque-Márquez Rafael, López-Cortés Luis Fernando, Martínez-Marcos Francisco J, de la Torre-Lima Javier, Plata-Ciézar Antonio, Hidalgo-Tenorio Carmen, García-López Maria Victoria, Vinuesa David, Gutiérrez-Valencia Alicia, Gil-Navarro Maria Victoria, De Alarcón Arístides
Unidad de Farmacia, Hospital Universitario Virgen del Rocío/CSIC/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain.
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/CSIC/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain.
J Clin Med. 2021 Dec 21;11(1):7. doi: 10.3390/jcm11010007.
Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple daily doses are required. AC regimens useful for OPAT programs include once-daily high-dose administration of ceftriaxone (AC24) or AC co-diluted and jointly administered in bolus every 4 h (ACjoined). In this retrospective analysis of prospectively collected cases, we aimed to assess the clinical effectivity and safety of three AC regimens for the treatment of IE. Fifty-nine patients were treated with AC combinations (AC12 = 32, AC24 = 17, and ACjoined = 10). Six relapses occurred in the whole cohort: five (29.4%) treated with AC24 regimen and one (10.0%) with ACjoined. Patients were cured in 30 (93.3%), 16 (94.1%), and eight (80.0%) cases in the AC12, AC24 and ACjoined groups, respectively. Unplanned readmission occurred in eight (25.0%), six (35.3%), and two (20.0%) patients in the AC12, AC24 and ACjoined groups, respectively. The outcome of patients with IE treated with AC in OPAT programs relies on an optimization of the delivery of the combination. AC24 exhibit an unexpected rate of failures, however, ACjoined might be an effective alternative which clinical results should corroborate in further studies.
氨苄西林加头孢曲松（AC）是治疗感染性心内膜炎（IE）的一种广为人知的住院治疗方案。在该方案中，头孢曲松通常每2小时给药2g（AC12）。在门诊肠外抗生素治疗（OPAT）项目中应用AC具有挑战性，因为需要每日多次给药。适用于OPAT项目的AC方案包括头孢曲松每日一次大剂量给药（AC24）或AC混合后每4小时静脉推注联合给药（ACjoined）。在这项对前瞻性收集病例的回顾性分析中，我们旨在评估三种AC方案治疗IE的临床有效性和安全性。59例患者接受了AC联合治疗（AC12 = 32例，AC24 = 17例，ACjoined = 10例）。整个队列中发生了6例复发：5例（29.4%）接受AC24方案治疗，1例（10.0%）接受ACjoined方案治疗。AC12、AC24和ACjoined组分别有30例（93.3%）、16例（94.1%）和8例（80.0%）患者治愈。AC12、AC24和ACjoined组分别有8例（25.0%）、6例（35.3%）和2例（20.
