Journal article
Infective Endocarditis Guidelines: The Challenges of Adherence-A Survey of Infectious Diseases Clinicians
Open forum infectious diseases, Vol.7(9), pp.ofaa342-ofaa342
09/01/2020
DOI: 10.1093/ofid/ofaa342
PMCID: PMC7489528
PMID: 32964063
Abstract
Background. Guidelines exist to aid clinicians in managing patients with infective endocarditis (IE), but the degree of adherence with guidelines by Infectious Disease (ID) physicians is largely unknown.
Methods. An electronic survey assessing adherence with selected IE guidelines was emailed to 1409 adult ID physician members of the Infectious Diseases Society of America's Emerging Infections Network.
Results. Five hundred fifty-seven physicians who managed IE responded. Twenty percent indicated that ID was not consulted on every case of IE at their hospitals, and 13% did not recommend transthoracic echocardiography (TTE) for all IE cases. The duration of antimicrobial therapy was timed from the first day of negative blood cultures by 91% of respondents. Thirty-four percent of clinicians did not utilize an aminoglycoside for staphylococcal prosthetic valve IE (PVE). Double beta-lactam therapy was "usually" or "almost always" employed by 83% of respondents for enterococcal IE. For patients with active IE who underwent valve replacement and manifested positive surgical cultures, 6 weeks of postoperative antibiotics was recommended by 86% of clinicians.
Conclusions. The finding that adherence was <90% with core guideline recommendations that all patients with suspected IE be seen by Ill and that all patients undergol"FE is noteworthy. Aminoglycoside therapy of IE appears to be declining, with double beta-lactam regimens emerging as the preferred treatment for enterococcal IE. The duration of postoperative antimicrobial therapy for patients undergoing valve replacement during acute IE is poorly defined and represents an area for which additional evidence is needed.
Details
- Title: Subtitle
- Infective Endocarditis Guidelines: The Challenges of Adherence-A Survey of Infectious Diseases Clinicians
- Creators
- Glen Huang - University of California, Los AngelesSiddhi Gupta - Atrium Health Wake Forest BaptistKyle A. Davis - Atrium Health Wake Forest BaptistErin W. Barnes - Atrium Health Wake Forest BaptistSusan E. Beekmann - University of IowaPhilip M. Polgreen - University of IowaJames E. Peacock - Atrium Health Wake Forest Baptist
- Resource Type
- Journal article
- Publication Details
- Open forum infectious diseases, Vol.7(9), pp.ofaa342-ofaa342
- DOI
- 10.1093/ofid/ofaa342
- PMID
- 32964063
- PMCID
- PMC7489528
- NLM abbreviation
- Open Forum Infect Dis
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Publisher
- Oxford University Press
- Number of pages
- 6
- Grant note
- 1 U50 CK00477 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
- Language
- English
- Date published
- 09/01/2020
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359678702771
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