The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna

a case study

Siobhan Chien, David Gorman, Charilaos Panagiotis Koutsogiannidis, Ramanish Ravishankar, Ganesh Kamath, Vipin Zamvar

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Finegoldia magna, a Gram-positive anaerobic coccus, is part of the human normal microbiota as a commensal of mucocutaneous surfaces. However, it remains an uncommon pathogen in infective endocarditis, with only eight clinical cases previously reported in the literature. Currently, infective endocarditis is routinely treated with prolonged intravenous antibiotic therapy. However, recent research has found that switching patients to oral antibiotics is non-inferior to prolonged parenteral antibiotic treatment, challenging the current guidelines for the treatment of infective endocarditis. CASE PRESENTATION: This case report focuses on a 52-year-old gentleman, who presented with initially culture-negative infective endocarditis following bioprosthetic aortic valve replacement. Blood cultures later grew Finegoldia magna. Following initial intravenous antibiotic therapy and re-do surgical replacement of the prosthetic aortic valve, the patient was successfully switched to oral antibiotic monotherapy, an unusual strategy in the treatment of infective endocarditis inspired by the recent publication of the POET trial. He made excellent progress on an eight-week course of oral antibiotics and was successfully discharged from surgical follow-up. CONCLUSIONS: This case is the 9th reported case of Finegoldia magna infective endocarditis in the literature. Our case also raises the possibility of a more patient-friendly and cost-effective means of providing long-term antibiotic therapy in suitable patients with prosthetic valve endocarditis and suggests that the principles highlighted in the POET trial can also be applicable to post-operative patients after cardiac surgery.

Original languageEnglish
Number of pages1
JournalJournal of Cardiothoracic Surgery
Volume14
Issue number1
DOIs
Publication statusPublished - 18-09-2019

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Endocarditis
Anti-Bacterial Agents
Aortic Valve
Therapeutics
Gram-Positive Cocci
Microbiota
Thoracic Surgery
Guidelines
Costs and Cost Analysis
Research

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Chien, Siobhan ; Gorman, David ; Koutsogiannidis, Charilaos Panagiotis ; Ravishankar, Ramanish ; Kamath, Ganesh ; Zamvar, Vipin. / The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna : a case study. In: Journal of Cardiothoracic Surgery. 2019 ; Vol. 14, No. 1.
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The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna : a case study. / Chien, Siobhan; Gorman, David; Koutsogiannidis, Charilaos Panagiotis; Ravishankar, Ramanish; Kamath, Ganesh; Zamvar, Vipin.

In: Journal of Cardiothoracic Surgery, Vol. 14, No. 1, 18.09.2019.

Research output: Contribution to journalArticle

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