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Andrea Colli
Riccardo Campodonico
Tiziano Gherli
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Right arrow Valve disease

Ann Thorac Surg 2007;84:87-91
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Early Switch From Vancomycin to Oral Linezolid for Treatment of Gram-Positive Heart Valve Endocarditis

Andrea Colli, MD*, Riccardo Campodonico, MD, Tiziano Gherli, MD

Department of Cardiac Surgery, University of Parma, Parma, Italy

Accepted for publication February 26, 2007.

* Address correspondence to Dr Colli, Department of Cardiovascular Surgery, Hospital Clinic, C. Villaroel 170, Barcelona, 08036, Spain (Email: colli.andrea{at}libero.it).

Background: Patients with complicated gram-positive endocarditis are usually treated with a combination of surgical procedure and long-term antibiotic therapy with intravenous vancomycin. However, oral linezolid offers the potential for an early switch from intravenous vancomycin to oral linezolid therapy.

Methods: We conducted a retrospective study from February 2002 to August 2005 to determine the potential for early switch from intravenous vancomycin to oral linezolid in patients surgically treated for a left-sided active gram-positive endocarditis.

Results: Fourteen patients were identified; average age was 52 ± 16 years. There were 10 (85%) and 2 (15%) cases of native and prosthetic valve endocarditis, respectively. Patients were operated on 3 to 10 days after diagnosis. There were no cases of operative mortality. Mean follow-up was 20.8 ± 7.0 months. Two (14%) patients died of noncardiac causes during follow-up. The mean intensive care unit length of stay was 3.1 ± 2.3 days, and mean hospital length of stay was 10.5 ± 3.4 days. No cases of recurrent endocarditis or periprosthetic leakage were observed.

Conclusions: The combination of aggressive surgical treatment and the early switch from intravenous vancomycin to oral linezolid for treatment of active gram-positive heart valve endocarditis is safe and effective, and reduces infection relapses, vancomycin use, hospital length of stay, and economic costs.






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