ArticleClinical cardiology1997
Effect of antibiotic treatment on vegetation size and complication rate in infective endocarditis.
Article in Clinical cardiology, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- [S2 Guideline for diagnosis and therapy of infectious endocarditis].Zeitschrift fur Kardiologie · 2004Guideline
- Deciphering the Complex Relationships Between the Hemostasis System and Infective Endocarditis.Journal of clinical medicine · 2025Review
- Embolic risk management in infective endocarditis: predicting the 'embolic roulette'.Open heart · 2025Review
- Blood culture-negative endocarditis caused by Bartonella quintana in Iran.Scientific reports · 2024Article
- Vegetation Length is Associated with Long-term Survival in Patients Treated Surgically for Infective Endocarditis.Reviews in cardiovascular medicine · 2024Article
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- Early surgical intervention in culture-negative endocarditis of the aortic valve complicated by abscess in an infant: A case report.World journal of clinical cases · 2021Article
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- Mitral stenosis produced by infective endocarditis involving a previously anatomically normal valve.Proceedings (Baylor University. Medical Center) · 2019Article
- Multiple systemic embolism in infective endocarditis underlying in Barlow's disease.BMC infectious diseases · 2016Article
- Re: complicated subacute bacterial endocarditis in a patient with ventricular septal defect.Sultan Qaboos University medical journal · 2014Article
- What size of vegetation is an indication for surgery in endocarditis?Interactive cardiovascular and thoracic surgery · 2012Review
- Biofilms: survival mechanisms of clinically relevant microorganisms.Clinical microbiology reviews · 2002Review
- Antibacterials for the prophylaxis and treatment of bacterial endocarditis in children.Paediatric drugs · 2001Review
- Platelet depletion and severity of streptococcal endocarditis.The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses · 1998Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfective endocarditis is associated with significant morbidity and mortality, with valvular destruction, and with congestive heart failure. Embolic events are more common in patients with echocardiographically discernible vegetations, especially when vegetations are > 10 mm in diameter. HYPOTHESIS: The objective of the study was to follow vegetation morphology during native valve endocarditis, to compare it with the clinical course and antibiotic treatment chosen, and to evaluate whether the impact on vegetation size and complication rate of antibiotic regimens differed in patients with positive and negative blood cultures.
methodsThe effect of different antibiotic regimes on vegetation size monitored by using transesophageal echocardiography was evaluated in 183 patients with echocardiographic evidence of infective endocarditis. A total of 223 vegetations attached to the aortic or mitral valves were detected using the transesophageal approach. The patients were followed for a mean of 76 weeks and underwent a minimum of two consecutive transesophageal echocardiographic examinations.
resultsTreatment with different kinds of antibiotics corresponded with significant differences in vegetation size; vancomycin-associated treatment was related to a 45% reduction, ampicillin to a 19% reduction, penicillin to a 5% reduction, penicillase-resistant drugs to a 15% increase, and cephalosporin to a 40% increase in vegetation size. Multivariate analysis showed that penicillin, cephalosporin, and penicillase-resistant drug treatments were associated with an increased embolic risk, vancomycin treatment with abscess formation, and cephalosporin medication with increased mortality. Plotting changes in vegetation size against the incidence of embolism and mortality, linear regression analysis suggested a 40-50% reduction in vegetation size, thereby greatly reducing the risk of embolism and mortality.
conclusionOur study shows that different antibiotics have different effects on vegetation size. The highest complication rate was observed when vegetations significantly increased in size during antibiotic treatment. Especially in culture-negative patients, monitoring vegetation size by means of transesophageal echocardiography may prove to be useful for estimating the efficacy of antibiotic treatment.
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