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The actual burden of infective endocarditis (IE) is unknown.1 The scarcity of data from low-income countries is considered to be one reason for this,1 and heterogeneity in the design of other epidemiological studies is another. In 2020, IE continues to be a complex problem in medicine. The multiplicity of pathogens which cause IE, the increasing prevalence of intracardiac devices and the increasingly recognised need for surgery, as well as the different complications which can occur, explain why it is so difficult to choose an antibiotic regimen to treat any one patient with IE.2
Proper treatment of patients with IE requires a team made up of specialists in microbiology, infectious diseases, cardiology, including subspecialists with interest in imaging and cardiothoracic surgery.3 Finally, undoubtedly, there remain gaps in the evidence as to how best to manage IE.4 The basis of this Cochrane review was to assess the clinical benefits and harms of different antibiotic regimens to treat people with IE.5
The review by Martí-Carvajal et al is an update of a prior Cochrane review.5 The research question was ‘What are the clinical benefits and harms of the different antibiotic regimens used to treat people with IE?’ The updated search used the primary databases (the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase Classic and Embase, LILACS, CINAHL, and the Conference Proceedings Citation Index–Science) from 2016 until 6 January 2020. The randomised controlled trials (RCTs) included in this updated analysis assessed antibiotic regimens' effects to treat definite cases of IE diagnosed according to modified Duke criteria. The primary outcomes were all-cause mortality, cure rates and adverse events. People with possible IE and pregnant women were excluded. Trials with mixed populations were included, that is, trials where only a subset of participants met eligibility criteria. We …
Contributors AJM-C is the sole author of this article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer This review is an abridged version of a Cochrane Review previously published in the Cochrane Database of Systematic Reviews XXXX, IssueX8, DOI: /10.1002/14651858.CD00XXXX.pub4 (see www. cochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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