eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2020
vol. 17
 
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abstract:
Review paper

Infective endocarditis – can we treat it more effectively?

Aneta Guzek
1
,
Wojciech Braksator
2
,
Zbigniew Gąsior
3
,
Mariusz Kuśmierczyk
4
,
Jacek Różański
4
,
Zbigniew Rybicki
5

1.
Department of Laboratory Diagnostics, Section of Microbiology, Military Institute of Medicine, Warsaw, Poland
2.
Department of Sports Cardiology and Noninvasive Cardiac Imaging, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
3.
Department of Cardiology, Medical University of Silesia, Katowice, Poland
4.
Department of Cardiac Surgery and Transplantology, Institute of Cardiology, Warsaw, Poland
5.
Department of Anesthesiology and Intensive Therapy, Military Institute of Medicine, Warsaw, Poland
Kardiochir Torakochir Pol 2020; 17 (1): 8-14
Online publish date: 2020/04/08
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Infective endocarditis (IE), despite the diagnostic and therapeutic advances, still remains a serious disease associated with high mortality and serious complications. The present guidelines of the European Cardiology Society of 2015 recommend administration of the antibiotics indicated in empirical therapy for multiple weeks and in targeted treatment often for 6–8 weeks. This is associated with a risk of adverse effects of antibiotic therapy in the form of nephro- and/or hepatotoxicity and an increased risk of infections with Clostridioides difficile, while long-term hospitalisation is associated with high non-drug costs. The recommendations developed by the Austrian Society for Infectious Diseases and Tropical Medicine list dalbavancin among the new antibiotics that may find application in the treatment of IE of staphylococcal aetiology. This antibiotic is a lipoglycopeptide antibiotic alternative to vancomycin in the treatment of Staphylococcus aureus MRSA infections, especially in a situation where the minimum inhibitory concentration for vancomycin is high but below the breakpoint. Dalbavancin has very good pharmacokinetic and pharmacodynamic properties, with a long duration of action of up to 14 days after administration of a single dose (1500 mg in a 30-minute infusion). This antibiotic is characterised by high clinical efficacy with good treatment tolerance and safety profile, without causing toxic effects in internal organs in comparison with vancomycin. In view of its safety, clinical efficacy and convenient dosing, dalbavancin may prove a useful therapeutic option in the treatment of IE.
keywords:

infective endocarditis, dalbavancin, echocardiography, Endocarditis Team

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