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Is the MIC useful in deciding to treat endocarditis surgically?
- Source :
-
International journal of antimicrobial agents [Int J Antimicrob Agents] 2004 Apr; Vol. 23 (4), pp. 394-7. - Publication Year :
- 2004
-
Abstract
- The infecting pathogen and its susceptibility to antibiotics is used to suggest prognosis in endocarditis. A case study was performed in a tertiary referral cardiology centre to assess the contribution of the measurement of minimum inhibitory concentration (MIC) to the decision to treat endocarditis surgically. The records were examined of 125 patients admitted between 1981 and 1999 in whom the minimum inhibitory concentration for the pathogen had been measured. The measures of outcome were mortality at time of hospital discharge and at 6 months, surgical referral and cure by medical treatment. Endocarditis caused by Staphylococcus aureus with a raised MIC of flucloxacillin (methicillin) was associated with higher mortality even if glycopeptides were used in treatment (< or = 35 mg/l 0/7 versus MIC 1-2 mg/l 4/13, P = 0.01). Elevated MICs of flucloxacillin in S. aureus infection or of gentamicin in streptococcal disease were associated with surgical intervention. There were no significant differences between bacterial pathogens in mortality, surgical referral or cure by medical treatment. The measurement of MIC appears prognostically important in deciding the surgical management of endocarditis.
- Subjects :
- Endocarditis, Bacterial microbiology
Endocarditis, Bacterial mortality
Female
Gentamicins pharmacology
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Penicillins pharmacology
Predictive Value of Tests
Staphylococcal Infections microbiology
Staphylococcal Infections mortality
Staphylococcal Infections surgery
Staphylococcus aureus drug effects
Streptococcal Infections microbiology
Streptococcal Infections mortality
Streptococcal Infections surgery
Streptococcus drug effects
Anti-Bacterial Agents pharmacology
Endocarditis, Bacterial surgery
Gram-Positive Cocci drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 0924-8579
- Volume :
- 23
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International journal of antimicrobial agents
- Publication Type :
- Academic Journal
- Accession number :
- 15081090
- Full Text :
- https://doi.org/10.1016/j.ijantimicag.2003.08.012