TY - JOUR 
A1 - Muñoz García, Patricia
AU - Villa, Sofía de la
AU - Martínez Sellés Oliveria Soares, Manuel
AU - Goenaga, Miguel Ángel
AU - Reviejo Jaka, Karlos
AU - Arnáiz de las Revillas, Francisco
AU - García Cuello, Luis
AU - Hidalgo Tenorio, Carmen
AU - Rodríguez Esteban, María Ascensión
AU - Bouza, Emilio
AU - Spanish Collaboration on Endocarditis, Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES)
AU - Et al.
T1 - Linezolid for infective endocarditis: A structured approach based on a national database experience
Y1 - 2021
SN - 0025-7974

UR - http://hdl.handle.net/11268/11539
AB - Current data on the frequency and efficacy of linezolid (LNZ) in infective endocarditis (IE) are based on small retrospective series. We used a national database to evaluate the effectiveness of LNZ in IE.This is a retrospective study of IE patients in the Spanish GAMES database who received LNZ. We defined 3 levels of therapeutic impact: LNZ < 7 days, LNZ high-impact (≥ 7 days, > 50% of the total treatment, and > 50% of the LNZ doses prescribed in the first weeks of treatment), and LNZ ≥ 7 days not fulfilling the high-impact criteria (LNZ-NHI). Effectiveness of LNZ was assessed using propensity score matching and multivariate analysis of high-impact cases in comparison to patients not treated with LNZ from the GAMES database matched for age-adjusted comorbidity Charlson index, heart failure, renal failure, prosthetic and intracardiac IE device, left-sided IE, and Staphylococcus aureus. Primary outcomes were in-hospital mortality and one-year mortality. Secondary outcomes included IE complications and relapses.From 3467 patients included in the GAMES database, 295 (8.5%) received LNZ. After excluding 3 patients, 292 were grouped as follows for the analyses: 99 (33.9%) patients in LNZ < 7 days, 11 (3.7%) in LNZ high-impact, and 178 (61%) in LNZ-NHI. In-hospital mortality was 51.5%, 54.4%, and 19.1% respectively. In the propensity analysis, LNZ high-impact group presented with respect to matched controls not treated with LNZ higher in-hospital mortality (54.5% vs 18.2%, P = .04). The multivariate analysis showed an independent relationship of LNZ use with in-hospital mortality (odds ratio 9.06, 95% confidence interval 1.15--71.08, P = .03).Treatment with LNZ is relatively frequent, but most cases do not fulfill our high-impact criteria. Our data suggest that the use of LNZ as definitive treatment in IE may be associated with higher in-hospital mortality.
KW - Endocarditis bacteriana
KW - Linezolid
KW - Signos y síntomas
KW - Enfermedad cardiovascular
KW - Tratamiento médico
LA - eng
ER -