Postoperative Antibiotic Management Duration Following Surgery for Intravenous Drug Abuse (IVDA) Endocarditis (OPTIMAL)

Launched by VINAY BADHWAR · Nov 30, 2021

Keywords

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Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • The age of the patient is ≥ 18.
• • The patient has undergone an urgent or emergent primary cardiac valvar operation as treatment for IVDA endocarditis, with blood cultures positive for Streptococcus, Enterococcus faecalis, Staphylococcus aureus, or coagulase-negative Staphylococci
• • The patient has received 2 weeks of postoperative inpatient IV antibiotic therapy with negative blood cultures and no residual active infection by imaging (i.e. computerized axial tomography, echocardiography)
• • The patient has the capacity to participate in a compliance tracking tool for medication administration (e.g. a centrally managed core site mobile Medisafe compliance https://www.medisafe.com/) as confirmed by both a physician and a care management team member
• Exclusion Criteria:
• • Inability to give informed consent
• • Residual infection requiring IV antibiotic therapy
• • Any persistent secondary noncardiac infection (e.g. infections of solid organs or joints)
• • Known poor compliance or deemed incapable to comply with the compliance tracking tool
• • Reduced absorption or inability to receive oral treatment due to a gastrointestinal disorder
• • Any infection involving a more virulent organisms, such as fungal infections or infections with Serratia or HACEK infections (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella).
• • Cancer not otherwise in remission or in need of current or future oncologic therapy
• • Medically immunocompromised state
• • Reoperative valvar operation for IVDA endocarditis
• • History of habitual noncompliance
• • Pregnancy
• • Mental incapacity
• • Unable to perform local or institutional medical and psychiatric follow up
• • Unstable home environment
• • Inadequate access to mobile cell service (geographic/rurality)