infective endocarditis

Making friends.

The article, Should Valve Leaflet Thickening Be Considered a Characteristic Lesion of Infective Endocarditis?, published in CID.

Um, so I'm gonna be a little didactic here, get me in trouble.

So we get these criteria, then there's this validation period, right? So I, I got something to point out.

So it's kind of interesting that we're incorporating valve leaflet thickening in a diagnost- diagnostic paradigm 'cause we actually, w-we, we didn't know ahead if this was a good idea.

So here they're actually gonna ask that question.

Um, after the fact, if valve leaflet thickening, which was recently incorporated into the 2023 version of the Duke criteria by the European Society of Cardiology as a potential image marker of infective endocarditis, is a good idea, or will this end up substantially reducing diagnostic specificity and just diagnosing too many folks with endocarditis that do not have it? Isn't valve thickening common with aging, and this is just some kind of random age bias? The group performed a retrospective study that included adults with suspected, um, IE, infective endocarditis, um, at Lausanne University Hospital, 2014, 2025.

These folks at the, uh, Lausanne University Hospital in Lausanne are publishing some good stuff lately.

So this was published a couple of days ago in the New England Journal.

The formal title, Response-Tailored or Standard Duration Antibiotic Treatment for Infective Endocarditis.

So I will do my best for us to summarize this here.

As most of our ID audiences aware, we have had this kind of long standing paradigm of four to six weeks of IV therapy for endocarditis.

So before randomization, all the patients received at least two to four weeks of of therapy, met criteria for clinical stabilization, and then they are randomized.

And the patients in the tailored therapy group discontinue antibiotics and those in the standard therapy group continue to that, you know, typically four to six weeks.

The primary efficacy endpoint was days alive without antibiotic treatment for infective endocarditis or bacteremia within six months after randomization.

The primary safety endpoint was a composite of death from any cause, unplanned cardiac surgery, symptomatic embolic events within six months after randomization.