Outpatient Parenteral Antibiotic Treatment for Infective Endocarditis: A Prospective Cohort Study From the GAMES Cohort


Por: Llopis, J, Gonzalez-Ramallo, V, Goenaga, M, Garcia-Leoni, M, Farinas, M, Oteo, J, Carrizo, E, Reguera-Iglesias, J, Hidalgo-Tenorio, C, Sanchez, F, Noureddine, M, Rosas, G, Lima, J, Blanco, R, Boado, M, Lazaro, M, Crespo, A, Goikoetxea, J, Iruretagoyena, J, Zuazabal, J, Lopez-Soria, L, Montejo, M, Nieto, J, Rodrigo, D, Rodriguez, R, Vitoria, Y, Voces, R, Lopez, M, Georgieva, R, Ojeda, G, Bailon, I, Morales, J, Cuende, A, Echeverria, T, Fuerte, A, Gaminde, E, Goenaga, M, Idigoras, P, Iribarren, J, Yarza, A, Urkola, X, Reviejo, C, Carrasco, R, Climent, V, Llamas, P, Merino, E, Plazas, J, Reus, S, Alvarez, N, Bravo-Ferrer, J, Castelo, L, Cuenca, J, Llinares, P, Rey, E, Mayo, M, Sanchez, E, Regueiro, D, Martinez, F, Alonso, M, Castro, B, Rosado, D, Duran, M, Gomez, M, Lacalzada, J, Nassar, I, Ciezar, A, Iglesias, J, Alvarez, V, Costas, C, de la Hera, J, Suarez, J, Fraile, L, Arguero, V, Menendez, J, Bajo, P, Morales, C, Torrico, A, Palomo, C, Martinez, B, Esteban, A, Garcia, R, Asensio, M, Almela, M, Ambrosioni, J, Azqueta, M, Brunet, M, Bodro, M, Cartana, R, Falces, C, Fita, G, Fuster, D, de la Maria, C, Garcia-Valls, L, Hernandez-Meneses, M, Perez, J, Marco, F, Miro, J, Moreno, A, Nicolas, D, Ninot, S, Quintana, E, Pare, C, Pereda, D, Pericas, J, Pomar, J, Ramirez, J, Rovira, I, Sandoval, E, Sala, M, Sitges, M, Soy, D, Tellez, A, Tolosana, J, Vidal, B, Vila, J, Adan, I, Bermejo, J, Bouza, E, Celemin, D, Caballero, G, Montero, A, Cruz, A, Mansilla, A, Leoni, M, Ramallo, V, Hernandez, M, Hualde, A, Marin, M, Martinez-Selles, M, Menarguez, M, Munoz, P, Rincon, C, Rodriguez-Abella, H, Rodriguez-Creixems, M, Pinilla, B, Pinto, A, Valerio, M, Vazquez, P, Moreno, E, Antorrena, I, Loeches, B, Quiros, A, Moreno, M, Ramirez, U, Baston, V, Romero, M, Saldana, A, Balbin, J, Castillo, C, Arnaiz, A, Revillas, F, Belaustegui, M, Farinas, M, Farinas-Alvarez, C, Izquierdo, R, Garcia, I, Rico, C, Gutierrez-Cuadra, M, Diez, J, Pajaron, M, Parra, J, Teira, R, Zarauza, J, Dominguez, F, Pavia, P, Gonzalez, J, Orden, B, Ramos, A, Centella, T, Hermida, J, Moya, J, Martin-Davila, P, Navas, E, Oliva, E, del Rio, A, Stuart, J, Rodriguez, S, Tenorio, C, Delia, M, Araji, O, Barquero, J, Jambrina, R, de Cueto, M, Acebal, J, Mendez, I, Morales, I, Lopez-Cortes, L, de Alarcon, A, Garcia, E, Haro, J, Lepe, J, Lopez, F, Luque, R, Alonso, L, Azcarate, P, Gutierrez, J, Blanco, J, Garcia-Alvarez, L, Oteo, J, Sanz, M, de Benito, N, Gurgui, M, Pacho, C, Pericas, R, Pons, G, Alvarez, M, Fernandez, A, Martinez, A, Prieto, A, Regueiro, B, Tijeira, E, Vega, M, Blasco, A, Mollar, J, Arana, J, Uriarte, O, Lopez, A, de Zarate, Z, Matos, J, Dominguez, G, Sanchez-Porto, A, Leal, J, Vazquez, E, Torres, A, Blazquez, A, Valenzuela, G, Alonso, A, Aramburu, J, Calvo, F, Rodriguez, A, Tarabini-Castellani, P, Galvez, E, Bellido, C, Pau, J, Sepulveda, M, Sierra, P, Iqbal-Mirza, S, Alcolea, E, Serrano, P, Roca, J, Yanez, I, Ballesta, A, Soriano, V, Escobar, E, Monje, A, Cabrera, V, Garcia, D, Asenjo, M, Luna, C, Morcillo, J, Seco, M, Gelabert, A, Guallar, C, Abad, N, Mangas, P, Adell, M, Ruiz, M, Porres, J, Vidal, B, Trigueros, N, Espin, M, Caro, J, Sanchez, R, Almazan, A, Freire, A, Gonzalez, M, Ramis, P, Blanco, M, Bordes, E, Bonet, L, Munera, M, Garaizabal, E, Martinez, A, Luque, J and Spanish Collaboration Endocarditis

Publicada: 15 nov 2019
Resumen:
Background. Outpatient parenteral antibiotic treatment (OPAT) has proven efficacious for treating infective endocarditis (IE). However, the 2001 Infectious Diseases Society of America (IDSA) criteria for OPAT in IE are very restrictive. We aimed to compare the outcomes of OPAT with those of hospital-based antibiotic treatment (HBAT). Methods. Retrospective analysis of data from a multicenter, prospective cohort study of 2000 consecutive IE patients in 25 Spanish hospitals (2008-2012) was performed. Results. A total of 429 patients (21.5%) received OPAT, and only 21.7% fulfilled IDSA criteria. Males accounted for 70.5%, median age was 68 years (interquartile range [IQR], 56-76), and 57% had native-valve IE. The most frequent causal microorganisms were viridans group streptococci (18.6%), Staphylococcus aureus (15.6%), and coagulase-negative staphylococci (14.5%). Median length of antibiotic treatment was 42 days (IQR, 32-54), and 44% of patients underwent cardiac surgery. One-year mortality was 8% (42% for HBAT; P < .001), 1.4% of patients relapsed, and 10.9% were readmitted during the first 3 months after discharge (no significant differences compared with HBAT). Charlson score (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.42; P = .01) and cardiac surgery (OR, 0.24; 95% CI, .09-.63; P = .04) were associated with 1-year mortality, whereas aortic valve involvement (OR, 0.47; 95% CI, .22-.98; P = .007) was the only predictor of 1-year readmission. Failing to fulfill IDSA criteria was not a risk factor for mortality or readmission. Conclusions. OPAT provided excellent results despite the use of broader criteria than those recommended by IDSA. OPAT criteria should therefore be expanded.

Filiaciones:
Llopis, J:
 Univ Barcelona, Hosp Clin Barcelona, Inst Recerca Augusti Pi & Sunyer, Barcelona, Spain

Gonzalez-Ramallo, V:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

 Univ Complutense Madrid, Inst Invest Sanitaria Gregorio Maranon, Ctr Invest Biomed Red Enfermedades Resp CIBERES, CB06 06 0058,Dept Med, Madrid, Spain

Goenaga, M:
 Hosp Donostia, San Sebastian, Spain

Garcia-Leoni, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

 Univ Complutense Madrid, Inst Invest Sanitaria Gregorio Maranon, Ctr Invest Biomed Red Enfermedades Resp CIBERES, CB06 06 0058,Dept Med, Madrid, Spain

Farinas, M:
 Univ Cantabria, Hosp Univ Marques de Valdecilla, Santander, Spain

Oteo, J:
 Hosp San Pedro de la Rioja, Logrono, Spain

Carrizo, E:
 Hosp Univ Araba Txagorritxu, Gasteiz, Spain

Reguera-Iglesias, J:
 Hosp Reg Univ Malaga, Malaga, Spain

Hidalgo-Tenorio, C:
 Hosp Virgen de las Nieves, Complejo Hosp Granada, Granada, Spain

Sanchez, F:
 Hosp Costa del Sol, Marbella, Spain

Noureddine, M:
 Hosp Costa del Sol, Marbella, Spain

Rosas, G:
 Hosp Costa del Sol, Marbella, Spain

Lima, J:
 Hosp Costa del Sol, Marbella, Spain

Blanco, R:
 Hosp Univ Cruces, Bilbao, Spain

Boado, M:
 Hosp Univ Cruces, Bilbao, Spain

Lazaro, M:
 Hosp Univ Cruces, Bilbao, Spain

Crespo, A:
 Hosp Univ Cruces, Bilbao, Spain

Goikoetxea, J:
 Hosp Cruces, Baracaldo, Spain

 Hosp Univ Cruces, Bilbao, Spain

Iruretagoyena, J:
 Hosp Univ Cruces, Bilbao, Spain

Zuazabal, J:
 Hosp Univ Cruces, Bilbao, Spain

Lopez-Soria, L:
 Hosp Univ Cruces, Bilbao, Spain

Montejo, M:
 Hosp Univ Cruces, Bilbao, Spain

Nieto, J:
 Hosp Univ Cruces, Bilbao, Spain

Rodrigo, D:
 Hosp Univ Cruces, Bilbao, Spain

Rodriguez, R:
 Hosp Univ Cruces, Bilbao, Spain

Vitoria, Y:
 Hosp Univ Cruces, Bilbao, Spain

Voces, R:
 Hosp Univ Cruces, Bilbao, Spain

Lopez, M:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Georgieva, R:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Ojeda, G:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Bailon, I:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Morales, J:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Cuende, A:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Echeverria, T:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Fuerte, A:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Gaminde, E:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Goenaga, M:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Idigoras, P:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Iribarren, J:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Yarza, A:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Urkola, X:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Reviejo, C:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

:
 Hosp Gen Univ Alicante, Alicante, Spain

:
 Hosp Gen Univ Alicante, Alicante, Spain

:
 Hosp Gen Univ Alicante, Alicante, Spain

:
 Hosp Gen Univ Alicante, Alicante, Spain

:
 Hosp Gen Univ Alicante, Alicante, Spain

:
 Hosp Gen Univ Alicante, Alicante, Spain

Alvarez, N:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Bravo-Ferrer, J:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Castelo, L:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Cuenca, J:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Llinares, P:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Rey, E:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Mayo, M:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Sanchez, E:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Regueiro, D:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Martinez, F:
 Complejo Hosp Univ Huelva, Huelva, Spain

Castro, B:
 Hosp Univ Canarias, Canarias, Spain

Rosado, D:
 Hosp Univ Canarias, Canarias, Spain

Duran, M:
 Hosp Univ Canarias, Canarias, Spain

Gomez, M:
 Hosp Univ Canarias, Canarias, Spain

Lacalzada, J:
 Hosp Univ Canarias, Canarias, Spain

Nassar, I:
 Hosp Univ Canarias, Canarias, Spain

Ciezar, A:
 Hosp Reg Univ Malaga, Malaga, Spain

Iglesias, J:
 Hosp Reg Univ Malaga, Malaga, Spain

Alvarez, V:
 Hosp Univ Cent Asturias, Oviedo, Spain

Costas, C:
 Hosp Univ Cent Asturias, Oviedo, Spain

de la Hera, J:
 Hosp Univ Cent Asturias, Oviedo, Spain

Suarez, J:
 Hosp Univ Cent Asturias, Oviedo, Spain

Fraile, L:
 Hosp Univ Cent Asturias, Oviedo, Spain

Arguero, V:
 Hosp Univ Cent Asturias, Oviedo, Spain

Menendez, J:
 Hosp Univ Cent Asturias, Oviedo, Spain

Bajo, P:
 Hosp Univ Cent Asturias, Oviedo, Spain

Morales, C:
 Hosp Univ Cent Asturias, Oviedo, Spain

Torrico, A:
 Hosp Univ Cent Asturias, Oviedo, Spain

Palomo, C:
 Hosp Univ Cent Asturias, Oviedo, Spain

Martinez, B:
 Hosp Univ Cent Asturias, Oviedo, Spain

Esteban, A:
 Hosp Univ Cent Asturias, Oviedo, Spain

Garcia, R:
 Hosp Univ Cent Asturias, Oviedo, Spain

Asensio, M:
 Hosp Univ Cent Asturias, Oviedo, Spain

Almela, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Ambrosioni, J:
 Univ Barcelona, Hosp Clin Barcelona, Inst Recerca Augusti Pi & Sunyer, Barcelona, Spain

 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Azqueta, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Brunet, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Bodro, M:
 Univ Barcelona, Hosp Clin Barcelona, Inst Recerca Augusti Pi & Sunyer, Barcelona, Spain

 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Cartana, R:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Falces, C:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Fita, G:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Fuster, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

de la Maria, C:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Garcia-Valls, L:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Hernandez-Meneses, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Perez, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Marco, F:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Miro, J:
 Univ Barcelona, Hosp Clin Barcelona, Inst Recerca Augusti Pi & Sunyer, Barcelona, Spain

 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Moreno, A:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Nicolas, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Ninot, S:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Quintana, E:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pare, C:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pereda, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pericas, J:
 Univ Barcelona, Hosp Clin Barcelona, Inst Recerca Augusti Pi & Sunyer, Barcelona, Spain

 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pomar, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Ramirez, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Rovira, I:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Sandoval, E:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Sala, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Sitges, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Soy, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Tellez, A:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Tolosana, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Vidal, B:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Vila, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Adan, I:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Bermejo, J:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Bouza, E:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Celemin, D:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Caballero, G:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Montero, A:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Cruz, A:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Mansilla, A:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Leoni, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Ramallo, V:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Hernandez, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Hualde, A:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Marin, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Martinez-Selles, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Menarguez, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Munoz, P:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

 Univ Complutense Madrid, Inst Invest Sanitaria Gregorio Maranon, Ctr Invest Biomed Red Enfermedades Resp CIBERES, CB06 06 0058,Dept Med, Madrid, Spain

Rincon, C:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Rodriguez-Abella, H:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Rodriguez-Creixems, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Pinilla, B:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Pinto, A:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Valerio, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Vazquez, P:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Moreno, E:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Antorrena, I:
 Hosp Univ La Paz, Madrid, Spain

Loeches, B:
 Hosp Univ La Paz, Madrid, Spain

Quiros, A:
 Hosp Univ La Paz, Madrid, Spain

Moreno, M:
 Hosp Univ La Paz, Madrid, Spain

Ramirez, U:
 Hosp Univ La Paz, Madrid, Spain

Baston, V:
 Hosp Univ La Paz, Madrid, Spain

Romero, M:
 Hosp Univ La Paz, Madrid, Spain

Saldana, A:
 Hosp Univ La Paz, Madrid, Spain

Balbin, J:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Castillo, C:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Arnaiz, A:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Revillas, F:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Belaustegui, M:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Farinas, M:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Farinas-Alvarez, C:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Izquierdo, R:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Garcia, I:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Rico, C:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Gutierrez-Cuadra, M:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Diez, J:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Pajaron, M:
 Univ Cantabria, Hosp Univ Marques de Valdecilla, Santander, Spain

 Hosp Univ Marques de Valdecilla, Santander, Spain

Parra, J:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Teira, R:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Zarauza, J:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Dominguez, F:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Pavia, P:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Gonzalez, J:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Orden, B:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Ramos, A:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Centella, T:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Hermida, J:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Moya, J:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Martin-Davila, P:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Navas, E:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Oliva, E:
 Hosp Univ Ramon & Cajal, Madrid, Spain

del Rio, A:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Stuart, J:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Rodriguez, S:
 Hosp Univ Ramon & Cajal, Madrid, Spain

Tenorio, C:
 Hosp Univ Virgen de las Nieves, Granada, Spain

Delia, M:
 Hosp Univ Virgen Macarena, Seville, Spain

Araji, O:
 Hosp Univ Virgen Macarena, Seville, Spain

Barquero, J:
 Hosp Univ Virgen Macarena, Seville, Spain

Jambrina, R:
 Hosp Univ Virgen Macarena, Seville, Spain

de Cueto, M:
 Hosp Univ Virgen Macarena, Seville, Spain

Acebal, J:
 Hosp Univ Virgen Macarena, Seville, Spain

Mendez, I:
 Hosp Univ Virgen Macarena, Seville, Spain

Morales, I:
 Hosp Univ Virgen Macarena, Seville, Spain

Lopez-Cortes, L:
 Hosp Univ Virgen Macarena, Seville, Spain

de Alarcon, A:
 Hosp Univ Virgen del Rocio, Seville, Spain

Garcia, E:
 Hosp Univ Virgen del Rocio, Seville, Spain

Haro, J:
 Hosp Univ Virgen del Rocio, Seville, Spain

Lepe, J:
 Hosp Univ Virgen del Rocio, Seville, Spain

Lopez, F:
 Hosp Univ Virgen del Rocio, Seville, Spain

Luque, R:
 Hosp Univ Virgen del Rocio, Seville, Spain

Alonso, L:
 Hosp San Pedro, Logrono, Spain

Azcarate, P:
 Hosp San Pedro, Logrono, Spain

Gutierrez, J:
 Hosp San Pedro, Logrono, Spain

Blanco, J:
 Hosp San Pedro, Logrono, Spain

Garcia-Alvarez, L:
 Hosp San Pedro, Logrono, Spain

Oteo, J:
 Hosp San Pedro, Logrono, Spain

Sanz, M:
 Hosp San Pedro, Logrono, Spain

de Benito, N:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Gurgui, M:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pacho, C:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pericas, R:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pons, G:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Alvarez, M:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Fernandez, A:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Martinez, A:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

 Complejo Hosp Univ Albacete, Albacete, Spain

Prieto, A:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Regueiro, B:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Tijeira, E:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Vega, M:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Blasco, A:
 Hosp Santiago Apostol, Vitoria, Spain

Mollar, J:
 Hosp Santiago Apostol, Vitoria, Spain

Arana, J:
 Hosp Santiago Apostol, Vitoria, Spain

Uriarte, O:
 Hosp Santiago Apostol, Vitoria, Spain

Lopez, A:
 Hosp Santiago Apostol, Vitoria, Spain

de Zarate, Z:
 Hosp Santiago Apostol, Vitoria, Spain

Matos, J:
 Hosp Santiago Apostol, Vitoria, Spain

Dominguez, G:
 Hosp SAS Linea Concepcion, Cadiz, Spain

Sanchez-Porto, A:
 Hosp SAS Linea Concepcion, Cadiz, Spain

Leal, J:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Vazquez, E:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Torres, A:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Blazquez, A:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Valenzuela, G:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Alonso, A:
 Hosp Univ Canarias, Canarias, Spain

 Hosp Txagorritxu, Vitoria, Spain

Aramburu, J:
 Hosp Txagorritxu, Vitoria, Spain

Calvo, F:
 Hosp Txagorritxu, Vitoria, Spain

Rodriguez, A:
 Hosp Txagorritxu, Vitoria, Spain

Tarabini-Castellani, P:
 Hosp Txagorritxu, Vitoria, Spain

Galvez, E:
 Hosp Virgen de la Salud, Toledo, Spain

Bellido, C:
 Hosp Virgen de la Salud, Toledo, Spain

Pau, J:
 Hosp Virgen de la Salud, Toledo, Spain

Sepulveda, M:
 Hosp Virgen de la Salud, Toledo, Spain

Sierra, P:
 Hosp Virgen de la Salud, Toledo, Spain

Iqbal-Mirza, S:
 Hosp Virgen de la Salud, Toledo, Spain

Alcolea, E:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Serrano, P:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Roca, J:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Yanez, I:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Ballesta, A:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Soriano, V:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Escobar, E:
 Hosp Univ San Cecilio, Granada, Spain

Monje, A:
 Hosp Univ San Cecilio, Granada, Spain

Cabrera, V:
 Hosp Univ San Cecilio, Granada, Spain

Garcia, D:
 Hosp Univ San Cecilio, Granada, Spain

Asenjo, M:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Luna, C:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Morcillo, J:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Seco, M:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Gelabert, A:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Guallar, C:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Abad, N:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Mangas, P:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Adell, M:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Ruiz, M:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Porres, J:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Vidal, B:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Trigueros, N:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Espin, M:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Caro, J:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Sanchez, R:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Almazan, A:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Freire, A:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Gonzalez, M:
 Hosp Gen Univ Santa Lucia, Cartagena, Colombia

Ramis, P:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Blanco, M:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Bordes, E:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Bonet, L:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Munera, M:
 Complejo Hosp Univ Albacete, Albacete, Spain

Garaizabal, E:
 Complejo Hosp Univ Albacete, Albacete, Spain

Martinez, A:
 Complejo Hosp Univ Albacete, Albacete, Spain

Luque, J:
 Complejo Hosp Univ Albacete, Albacete, Spain
ISSN: 10584838





CLINICAL INFECTIOUS DISEASES
Editorial
OXFORD UNIV PRESS INC, JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA, Estados Unidos America
Tipo de documento: Article
Volumen: 69 Número: 10
Páginas: 1690-1700
WOS Id: 000504060700013
ID de PubMed: 30649282
imagen Open Access

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