Outpatient parenteral antimicrobial therapy for infective endocarditis in patients over 80 years

Abstract

Objective: The incidence of infective endocarditis is progressively increasing, especially in elderly patients. Outpatient parenteral antibiotic therapy (OPAT) is being an excellent alternative for treatment, but advanced age is one of the relative contraindications. The aim of this study is to compare the characteristics and prognosis of patients less or more than 80 years, treated with OPAT.

Methods: One hundred and ninety four patients were included between 1996 and 2015, 31 of them older than 80 years.

Results: The most frequently affected valve is the aortic one, mainly native valves. Most used antibiotics are ceftriaxone, ampicillin, cloxacillin and daptomycin. Differences in surgery (39.9% vs 9.7%, p=0.001) and use of infusion pump (55.2% vs 35.5%; p= 0.044) were observed, under 80 years and older respectively. No differences in readmissions and mortality were observed.

Conclusions: OPAT could be considered an effective alternative for appropriately-selected elderly patients with infective endocarditis.