Clinical reality for adjunctive rifampin usage in infective endocarditis treatment

Abstract

AIM: We aimed to determination of the area of adjunctıve rifampin usage in infectıve endocarditis (IE) endocarditis treatment. BACKGROUND: Current International infective endocarditis guidelines recommend rifampin-based combination treatments for staphylococcal prosthetic valve endocarditis (PVE). It is also a frequently used agent in the treatment of culture-negative endocarditis and brucella endocarditis. Because the rifampin tolerability is an important issue, full compliance with the guidelines in treatment management may not always be achieved. METHODS: This study was a multicenter, retrospective cohort study, performed between 2019-2023. The patients used rifampin based combinations (RBC) were included in the study. Demographic, imaging, microbiological and clinical data were recorded. Descriptive statistical analysis was performed. RESULTS: Between January 2019 and December 2023; a total of 506 IE cases were detected. A total of 59 patients used RBC during treatment. The median duration of rifampin treatment in these patients was 34.5(2-200) days. 28 of these patients were staphylococcal endocarditis (20 prosthetic valve IE, 5 cardiac implanted electronic device IE, 3 native valve IE). Fourteen (23.7%) of these patients were followed-up as culture negative IE. The patients diagnosed with The median duration of RBC in brucella endocarditis patients (6) was 139(20-180) days. RBC was not used in 58.7% of patients with prosthetic staphylococcal infective endocarditis. Although not compliant with guideline recommendations, RBC was used in 11 patients with a median duration of 20 days. CONCLUSION: In order to determine the areas of use of rifampin, which is difficult to tolerate and has many drug interactions, in the treatment of endocarditis, needs further validation.

Keywords

• Rifampin
• infective endocarditis
• treatment