Impact of postoperative antibiotics duration on prognosis in patients with infective endocarditis underwent surgery.

배경: Infective endocarditis (IE) remains a major medical problem with high morbidity and mortality. Appropriate antibiotic treatment lowers the risk of embolism, recurrence, and long-term mortality. However, there are concerns about adverse drug reactions and resistant strains due to long-term use of antibiotics. Therefore, we compared the difference in overall mortality according to the duration of postoperative antibiotics therapy in patients with IE. 방법: From 2005 to 2017, we retrospectively reviewed 416 patients with IE at a 2400-bed tertiary hospital in South Korea. A total of 234 IE patients who underwent valve surgery and appropriate duration of antibiotics were enrolled. They were divided into two groups based on the 2 weeks of postoperative antibiotic therapy. The primary outcome was long-term overall all-cause mortality. The secondary outcomes were reoperation rate, recurrence rate, and postoperative complications. 결과: The median follow-up duration was 71 (interquartile range [IQR], 46–109) months. The duration of postoperative antibiotic therapy was less than 2 weeks in 62 patients (26.5%) and more than 2 weeks in 172 patients (73.5%). The median age was 53 ([IQR], 39–63) years. The overall mortality was 12.8% (30/234). There were no statistical differences in overall mortality (12.9% vs. 12.8%, p=0.982), reoperation (6.5% vs. 4.1%, p=0.488), and recurrence (8.1% vs. 2.9%, p=0.135) between patients with postoperative antibiotic therapy less than 2 weeks and for ≥2 weeks, respectively. The duration of postoperative antibiotic therapy based on 2 weeks in the Kaplan-Meier curve was not associated with overall mortality (log-rank test, p=0.877). 결론: In conclusion, there was no statistically significant difference in the overall mortality, recurrence, and reoperation rate according to the duration of postoperative antibiotic therapy. If surgery and recommended total antibiotic duration are properly performed, a shorter duration of postoperative antibiotics might be considered. [ABSTRACT FROM AUTHOR]