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Abstract Objectives Clinical experience in the use of teicoplanin for treating enterococcal infective endocarditis (EIE) is scarce. The aim of this study was to describe the characteristics and outcomes of patients with EIE treated with teicoplanin monotherapy compared to standard therapy with ampicillin plus ceftriaxone. Methods All consecutive adult patients diagnosed with EIE between January 2018 and September 2022 at a referral centre were reviewed. Characteristics of individuals treated with teicoplanin for ≥14 days the treated with teicoplanin (TT) group were compared with those who received ampicillin plus ceftriaxone (AC group). Results Sixty-six patients were included 61 (92%) E. faecalis infective endocarditis (IE) and 5 (8%) E. faecium IE. Twenty-seven (41%) received teicoplanin: eight as first-line treatment and 19 as continuation therapy. The median duration of teicoplanin treatment was 30 (25–43) days. Surgery was indicated in 14/27 (52%) in the TT group and in 21/39 (54%) in the AC group, but was finally performed in 11/14 (79%) and 13/21 (62%) (P = 0.46), respectively. In-hospital mortality rate was 3/27 (11%) in the TT group and 12/39 (31%) in the AC group (P = 0.06). Patients treated with teicoplanin were more often discharged on outpatient parenteral antibiotic therapy 18/27 (67%) versus 6/39 (15%), P 0.001 and median hospital stay was shorter 29 days (IQR 20–61) versus 50 days (IQR 43–68), P = 0.006. One-year cumulative mortality was 8/27 (30%) in the TT group and 13/39 (33%) in the AC group (P = 0.46). There was one relapse in each group. Conclusion Teicoplanin seems an effective treatment for selected patients with enterococcal IE, mainly to facilitate discharge.
Villamarín et al. (Thu,) studied this question.