导航扰乱的水域:对假内心炎的系统审查报告了用抑制性抗微生物治疗治疗的病例
Pietro Valsecchi1, Matteo Calia2, Paola Giordani2
1Infectious Diseases I Unit, Fondazione IRCCS Policlinico San Matteo, Str. Privata Campeggi, 55, 27100 Pavia PV, Italy.
概括
在非手术候选人中,对假体内心炎 (PVE) 的抑制性抗菌治疗 (SAT) 的支持证据很少. 虽然一般耐受性很好,但由于死亡风险很大,它的有效性需要进一步评估.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 假内心炎 (PVE) 具有重大风险,特别是对于不适合进行手术的患者.
- 抑制性抗微生物治疗 (SAT) 是PVE的另一种管理策略.
研究的目的:
- 描述抑制性抗微生物治疗 (SAT) 的结果,这些患者患有假内心炎 (PVE),而不是手术的候选人.
- 评估PVE的长期SAT的有效性和安全性.
主要方法:
- 对PVE患者接受SAT治疗超过8周的研究的PubMed和Embase数据库的系统审查.
- 包括来自91项研究的个体患者数据,共170名患者.
- 分析与PVE相关的死亡,复发率和SAT相关的不良事件.
主要成果:
- 与PVE相关的死亡发生在15.57%的患者中,与凝结酶阴性葡萄球菌PVE相关.
- 复发率是相似的,不管SAT停止 (8.92%).
- 15%的患者报告了与SAT相关的不良事件.
结论:
- 支持PVE的SAT证据有限,主要来自病例报告和系列.
- SAT似乎耐受良好,但由于死亡率,临床有效性需要进一步评估.
- 在SAT上对PVE患者进行密切的长期随访至关重要,特别是如果停止治疗.
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