Antibiotic treatment duration for isolated methicillin-susceptible Staphylococcus aureus native tricuspid valve endocarditis: a standardized multidisciplinary approach.

BACKGROUND

MSSA tricuspid valve infective endocarditis (TVIE) is associated with significant morbidity and there is not consensus surrounding the optimal duration of antibiotic therapy. We report the outcomes of treating MSSA TVIE endocarditis using a multidisciplinary team and cardiovascular infectious diseases consult service.

METHODS

Patients were identified from the multidisciplinary endocarditis team registry in a single-centre retrospective study.

RESULTS

Between 7 September 2021 and 7 September 2024, 34 patients, including 27 who inject drugs, with isolated native MSSA TVIE were identified. Patients received a median of 28 days (IQR 11-41) of antibiotics and 50% transitioned to oral antibiotics for a median of 14 days. There was one relapsed infection (2.9%) and one death at 90 days (2.9%). There was no difference in relapsed infection or mortality at 90 days for patients transitioned to oral therapy compared with IV (P = 0.52).

CONCLUSIONS

With a standardized approach to patient care, including a cardiovascular infectious diseases consult service and multidisciplinary team, patients with MSSA isolated TVIE without metastatic osteoarticular or spinal infections were successfully treated with antibiotic courses of ≤28 days with low rates of mortality and relapsed infection at 90 days.