Daptomycin compared to standard therapy for the treatment of native valve endocarditis | Enfermedades Infecciosas y Microbiología Clínica

array:23 ["pii" => "S0213005X1000042X" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2009.07.015" "estado" => "S300" "fechaPublicacion" => "2010-10-01" "aid" => "270" "copyright" => "Elsevier España, S.L.. All rights reserved" "copyrightAnyo" => "2009" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2010;28:498-503" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4950 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 4003 "PDF" => 932 ] ] "itemSiguiente" => array:18 [ "pii" => "S0213005X10000078" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2009.09.009" "estado" => "S300" "fechaPublicacion" => "2010-10-01" "aid" => "267" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2010;28:504-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5301 "formatos" => array:3 [ "EPUB" => 14 "HTML" => 4628 "PDF" => 659 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Peripheral facial palsy after varicella. Report of two cases and review of the literature" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "504" "paginaFinal" => "508" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Parálisis facial periférica posvaricela. Descripción de dos casos y revisión de la literatura" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Montserrat Muñoz-Sellart, Carolina García-Vidal, Sergio Martínez-Yelamos, Jordi Niubó, Pedro Fernández-Viladrich" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Montserrat" "apellidos" => "Muñoz-Sellart" ] 1 => array:2 [ "nombre" => "Carolina" "apellidos" => "García-Vidal" ] 2 => array:2 [ "nombre" => "Sergio" "apellidos" => "Martínez-Yelamos" ] 3 => array:2 [ "nombre" => "Jordi" "apellidos" => "Niubó" ] 4 => array:2 [ "nombre" => "Pedro" "apellidos" => "Fernández-Viladrich" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X10000078?idApp=UINPBA00004N" "url" => "/0213005X/0000002800000008/v2_201308271925/S0213005X10000078/v2_201308271925/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0213005X10000789" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2009.12.009" "estado" => "S300" "fechaPublicacion" => "2010-10-01" "aid" => "289" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2010;28:492-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 9103 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 7594 "PDF" => 1499 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Identificación bacteriana mediante espectrometría de masas matrix-assisted laser desorption ionization time-of-flight. Comparación con la metodología habitual en los laboratorios de Microbiología Clínica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "492" "paginaFinal" => "497" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Identifying bacteria using a matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometer. Comparison with routine methods used in clinical microbiology laboratories" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2600 "Ancho" => 1636 "Tamanyo" => 213629 ] ] "descripcion" => array:1 [ "es" => "A) Comparación del perfil de un aislamiento clínico de Escherichia coli con los recogidos en la base de datos Biotyper 2.0. B) Comparación del perfil de un aislamiento clínico de Staphylococcus aureus con los recogidos en la base de datos Biotyper 2.0. Aparecen en azul los perfiles de referencia de la base de datos, en verde los picos de la cepa clínica coincidentes con éstos, en amarillo los de coincidencia moderada y en rojo los no coincidentes." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Ferreira, Silvia Vega, Fernando Sánchez-Juanes, Magdalena González, Ana Herrero, Ma Carmen Muñiz, José Manuel González-Buitrago, Juan Luis Muñoz" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Ferreira" ] 1 => array:2 [ "nombre" => "Silvia" "apellidos" => "Vega" ] 2 => array:2 [ "nombre" => "Fernando" "apellidos" => "Sánchez-Juanes" ] 3 => array:2 [ "nombre" => "Magdalena" "apellidos" => "González" ] 4 => array:2 [ "nombre" => "Ana" "apellidos" => "Herrero" ] 5 => array:2 [ "nombre" => "Ma Carmen" "apellidos" => "Muñiz" ] 6 => array:3 [ "Iniciales" => "J.M." "nombre" => "José Manuel" "apellidos" => "González-Buitrago" ] 7 => array:2 [ "nombre" => "Juan Luis" "apellidos" => "Muñoz" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X10000789?idApp=UINPBA00004N" "url" => "/0213005X/0000002800000008/v2_201308271925/S0213005X10000789/v2_201308271925/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Daptomycin compared to standard therapy for the treatment of native valve endocarditis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "498" "paginaFinal" => "503" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Zeina Kanafani, Helen Boucher, Vance Fowler, Christopher Cabell, Bruno Hoen, José M. Miró, Tahaniyat Lalani, Gloria Vigliani, Marilyn Campion, Ralph Corey, Donald Levine" "autores" => array:11 [ 0 => array:3 [ "nombre" => "Zeina" "apellidos" => "Kanafani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "Helen" "apellidos" => "Boucher" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Vance" "apellidos" => "Fowler" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff3" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff4" ] ] ] 3 => array:3 [ "nombre" => "Christopher" "apellidos" => "Cabell" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff3" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff4" ] ] ] 4 => array:3 [ "nombre" => "Bruno" "apellidos" => "Hoen" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff5" ] ] ] 5 => array:3 [ "nombre" => "José" "apellidos" => "M. Miró" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff6" ] ] ] 6 => array:3 [ "nombre" => "Tahaniyat" "apellidos" => "Lalani" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff3" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff4" ] ] ] 7 => array:3 [ "nombre" => "Gloria" "apellidos" => "Vigliani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff7" ] ] ] 8 => array:3 [ "nombre" => "Marilyn" "apellidos" => "Campion" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff7" ] ] ] 9 => array:3 [ "nombre" => "Ralph" "apellidos" => "Corey" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff3" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff4" ] ] ] 10 => array:4 [ "nombre" => "Donald" "apellidos" => "Levine" "email" => array:1 [ 0 => "DLevine@med.wayne.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "h" "identificador" => "aff8" ] 1 => array:2 [ "etiqueta" => "¿" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:8 [ 0 => array:3 [ "entidad" => "American University of Beirut Medical Center, Beirut, Líbano" "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Tufts New England Medical Center, Boston, MA, Estados Unidos" "etiqueta" => "b" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Duke University Medical Center, NC, Estados Unidos" "etiqueta" => "c" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Duke Clinical Research Institute, Durham, NC, Estados Unidos" "etiqueta" => "d" "identificador" => "aff4" ] 4 => array:3 [ "entidad" => "Hôpital Saint-Jacques, Besançon, Francia" "etiqueta" => "e" "identificador" => "aff5" ] 5 => array:3 [ "entidad" => "Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, España" "etiqueta" => "f" "identificador" => "aff6" ] 6 => array:3 [ "entidad" => "Newton, MA, Estados Unidos" "etiqueta" => "g" "identificador" => "aff7" ] 7 => array:3 [ "entidad" => "Wayne State University School of Medicine, Detroit, MI, Estados Unidos" "etiqueta" => "h" "identificador" => "aff8" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparación entre daptomicina y la terapéutica estándar en el tratamiento de la endocarditis de la válvula natural" ] ] "textoCompleto" => "IntroductionImportant changes have occurred in recent years in the epidemiology of infective endocarditis (IE) caused by Staphylococcus aureus.<a class="elsevierStyleCrossRefs" href="#bib1">1,2</a> The observed increase in the incidence of the disease can be ascribed to the increase in frequency and complexity of invasive medical procedures performed on seriously ill patients with significant comorbidities.<a class="elsevierStyleCrossRefs" href="#bib3">3,4</a> Therefore, S. aureus endocarditis is currently a disease of elderly, debilitated, and hospitalized patients, in addition to the traditional, relatively healthy, injection drug abusers.<a class="elsevierStyleCrossRefs" href="#bib5">5–8</a> Also, as part of the global shift in the antimicrobial resistance pattern of S. aureus, more methicillin-resistant S. aureus (MRSA) strains are causing bacteremia and endocarditis, thereby contributing to the challenging nature of the problem.<a class="elsevierStyleCrossRefs" href="#bib9">9,10</a>The use of glycopeptides for the treatment of S. aureus endocarditis has been fraught with problems. Vancomycin-intermediate S. aureus isolates and heteroresistant strains have been increasingly reported.<a class="elsevierStyleCrossRefs" href="#bib11">11,12</a> Treatment failure with vancomycin has been described even when the minimum inhibitory concentrations (MICs) are well within the susceptible range (1–2mg/mL).<a class="elsevierStyleCrossRefs" href="#bib13">13,14</a> Alternative treatment strategies for MRSA are, therefore, needed.Daptomycin is a lipopeptide agent with rapid bactericidal activity against S. aureus.<a class="elsevierStyleCrossRef" href="#bib15">15</a> It is approved for the treatment of complicated skin and skin-structure infections at a dose of 4mg/kg/day.<a class="elsevierStyleCrossRef" href="#bib16">16</a> In an international, prospective, randomized trial of daptomycin vs standard therapy for S. aureus bacteremia (SAB)<a class="elsevierStyleCrossRef" href="#bib9">9</a> and S. aureus infective endocarditis, daptomycin was effective and less nephrotoxic than the comparator.<a class="elsevierStyleCrossRef" href="#bib17">17</a> It was subsequently approved for treatment of S. aureus bacteremia (SAB) and right-sided endocarditis (RIE) at a dose of 6mg/kg/day. Here we summarize the experience with IE in that trial.MethodsStudy design and patientsThis was an open-label, randomized, active-control study conducted between August 28, 2002, and February 16, 2005, in 44 sites in the United States and Western Europe. Patients were considered for enrollment in the study if they were at least 18 years of age and had at least 1 blood culture that was positive for S. aureus within 2 calendar days of initiating the study medication. Exclusion criteria included creatinine clearance less than 30mL/min and known osteomyelitis, polymicrobial bacteremia, or pneumonia. For a full list of the exclusion criteria, please refer to the initial publication.<a class="elsevierStyleCrossRef" href="#bib17">17</a> In the initial phases of the trial, patients with left-sided endocarditis (LIE) were excluded.Randomization, treatments, and outcomesEligible patients were randomly assigned to receive either daptomycin (CUBICIN®, Cubist Pharmaceuticals) at 6mg/kg/day or standard therapy, with either 1g vancomycin every 12h (for MRSA isolates) or 2g antistaphylococcal penicillin every 4h (for methicillin-susceptible S. aureus [MSSA] isolates). The duration of treatment was determined by the investigators based on the working diagnosis. All patients who had a high likelihood of LIE at randomization were randomly assigned to receive daptomycin, and all patients randomly assigned to receive standard therapy, also received 1mg/kg gentamicin every 8h for the first 4 days. All patients underwent transesophageal echocardiography (TEE) within 5 days of enrollment, as well as any necessary follow-up echocardiography. Additionally, all patients underwent diagnostic evaluation for metastatic foci of infection.The primary efficacy measure was the success rate in the modified intent-to-treat (MITT) population 6 weeks after the end of therapy. An independent external adjudication committee blinded to therapy, consisting of 5 infectious diseases experts, reviewed individual patient data to establish final diagnoses and outcomes. Overall success was defined as survival, clinical cure or improvement, and a documented clearance of bacteremia. In addition, patients who did not complete adequate therapy, who received potentially effective non-study antibiotics, or who did not have blood cultures taken 6 weeks after completion of therapy were considered “treatment failures.” In this analysis, we also describe clinical success based on the presence of all of the following criteria: survival, clinical outcome of cure or improvement, and resolution of S. aureus infection 6 weeks after the end of therapy.Entry and final diagnoses and duration of therapyEntry diagnoses were determined according to the modified Duke University criteria for IE.<a class="elsevierStyleCrossRef" href="#bib18">18</a> Final diagnoses were based on standard clinical definitions. Uncomplicated RIE (uRIE) was defined as definite or possible MSSA endocarditis in the absence of predisposing abnormalities or active infection of the mitral or aortic valve in a patient who actively uses injection drugs, has a serum creatinine level of less than 2.5mg/dL, and has no evidence of extrapulmonary sites of infection. Minimum duration of therapy for patients with uRIE ranged from 14 to 28 days. Complicated RIE (cRIE) was similarly defined, but patients also had extrapulmonary sites of infection, a serum creatinine level of at least 2.5mg/dL, or MRSA bacteremia, or did not use injection drugs. Patients with cRIE received a minimum of 28–42 days of therapy. Patients with LIE were treated for a minimum 28–42 days.Molecular analysisIn order to evaluate differences in the genotypic profiles of S. aureus isolates causing infections of variable severity, we compared S. aureus isolates causing LIE (usually the most serious infection) with those causing uncomplicated bacteremia (least serious infection). Pulsed-field gel electrophoresis (PFGE) on these isolates was performed as previously described.<a class="elsevierStyleCrossRef" href="#bib19">19</a> In addition, and following previously reported methodology,<a class="elsevierStyleCrossRef" href="#bib19">19</a> DNA extraction and polymerase chain reaction (PCR) assays were used to examine 33 bacterial determinants, including toxins, adhesins, agr groups I–IV, staphylococcal cassette chromosome mec (SCCmec) types I–IV, as well as other virulence genes.Statistical analysisBecause of the limited number of patients in each arm, only descriptive statistics were performed for this subgroup analysis.ResultsStudy populationOf the 235 patients included in the MITT population in the original study, 181 were thought to have definite or possible endocarditis on enrollment, according to the modified Duke criteria for IE. A total of 53 patients received a final diagnosis of IE. All 37 patients who fulfilled the Duke criteria for definite endocarditis at enrollment had IE as the final diagnosis. Of the 144 patients with possible endocarditis according to the Duke criteria, 15 (10%) had a final diagnosis of IE. An additional patient was initially classified in the group without endocarditis, but was subsequently found to have IE.Of the 53 patients with a final diagnosis of endocarditis, 28 were randomly assigned to receive daptomycin and 25 were randomly assigned to standard therapy. There were no major differences between the study arms with regard to baseline patient characteristics, risk factors for endocarditis, entry diagnoses, or final diagnoses (<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>). The most common type of IE in both groups was cRIE (25 patients, 47%), followed by LIE (18 patients, 34%) and uRIE (10 patients, 19%). The proportion of patients with MRSA IE was similar in both groups (46% for daptomycin vs 44% for the comparator). Clinical evidence of systemic inflammatory response syndrome was present in 22 patients treated with daptomycin (79%) and in 21 patients treated with standard therapy (84%). Sixteen patients randomly assigned to receive daptomycin completed the course of therapy and received a median of 27 days of treatment. In the comparator arm, 14 patients completed the course of therapy and received a median of 30 days of antibiotic treatment. Gentamicin was administered as study medication for 4 days to 1 patient in the daptomycin group and for a median of 5 days to all 25 patients in the comparator group. Twenty-two patients with IE (41%) received a diagnosis of septic pulmonary infarct during the first 5 days of the study (10 in the daptomycin arm and 12 in the comparator arm).<elsevierMultimedia ident="tbl1"></elsevierMultimedia>Outcomes of patients with RIEIn the MITT population, the overall success rates for patients with RIE treated with daptomycin were similar to those of the comparator MITT population (42% vs 44%; <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>). Clinical success rates in this group of patients were higher in both arms (63% vs 69%). No difference in outcome was observed between the treatment groups of patients with MRSA or MSSA infection, or in patients with septic pulmonary infarct. Mortality rates were comparable for daptomycin and standard therapy (0% vs 12%).<elsevierMultimedia ident="tbl2"></elsevierMultimedia>Outcomes of patients with LIEThe overall success rates with LIE were poor in both arms (11% vs 22%; <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>). None of the 9 patients with LIE with MRSA infection had a successful outcome. Mortality rates were 33% with daptomycin treatment and 56% with standard therapy. Only 3 patients with LIE underwent valve surgery (2 in the daptomycin arm, 1 in the comparator arm): 2 after treatment and 1 during treatment for IE.Treatment failureThe overall failure rates of daptomycin and standard therapy were comparable (54% vs 56%; <a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>). The most common reason for failure in both study groups was persisting or relapsing S. aureus infection or clinical failure (29% vs 28%). Patients receiving the comparator were more likely than those receiving daptomycin to experience treatment failure resulting from death, adverse events (AEs), or receipt of potentially effective non-study antibiotics.<elsevierMultimedia ident="tbl3"></elsevierMultimedia>SafetyDaptomycin was well tolerated. The overall incidence of drug-related AEs was lower in the daptomycin arm (32% vs 50%), but the difference was not statistically significant (P=0.27). The proportion of patients in whom treatment was discontinued because of AEs was slightly lower with daptomycin (21%) than with standard therapy (31%; P=0.54). Increases in creatine kinase levels (>500IU/L) were noted in 12% of patients taking daptomycin and in 4% of those who received standard therapy (P=0.61). Conversely, renal toxicity occurred in 21% of patients in the comparator arm and in 15% of patients in the daptomycin arm (P=0.73).Microbiological and molecular analysisThe minimum inhibitory concentrations (MICs) of vancomycin and daptomycin were determined at baseline. In both treatment arms, the vancomycin MICs ranged between 0.5 and 0.1μg/mL while the daptomycin MICs ranged between 0.12 and 0.5μg/mL.Regarding molecular analysis, no significant differences were seen in the distribution of virulence genes between the 2 groups of isolates (those causing LIE and those causing uncomplicated bacteremia), including toxins, adhesins, and other genes, such as the agr gene complex. In addition, the S. aureus isolates were similar with respect to SCCmec types, PFGE types, and antimicrobial susceptibility patterns.DiscussionIn a large cohort of 2212 patients enrolled in the International Collaboration on Endocarditis-Merged Database (ICE-MD), S. aureus was the most common pathogen in native-valve IE, affecting 34% of all patients with definite endocarditis.<a class="elsevierStyleCrossRef" href="#bib20">20</a> More recent results from the ICE-Prospective Cohort Study (ICE-PCS) confirm that IE is most frequently caused by S. aureus (31%; of which 27% are MRSA). As health care-associated MRSA infection rates are rapidly rising,<a class="elsevierStyleCrossRef" href="#bib1">1</a> there is growing concern about the continued use of vancomycin to treat serious and often life-threatening infections. Because of increasing MICs, identification of heteroresistant and vancomycin-intermediate S. aureus isolates, and clinical failures,<a class="elsevierStyleCrossRefs" href="#bib12">12,14</a> clinicians are searching for a new antistaphylococcal antibiotic. The results of this subgroup analysis show that daptomycin is an effective alternative to standard therapy for treatment of RIE caused by S. aureus.We found that the success rates among patients with septic pulmonary emboli who received daptomycin were promising. Although daptomycin is not indicated for the treatment of pneumonia due to drug inactivation by pulmonary surfactant,<a class="elsevierStyleCrossRef" href="#bib21">21</a> the findings in this study constitute important evidence that daptomycin is effective in treating septic pulmonary emboli concomitant with IE. This can be explained because septic pulmonary emboli are, by definition, hematogenously spread and result in tissue infarction. Therefore, inactivation of daptomycin by surfactant should be less relevant than with lower respiratory tract infections.<a class="elsevierStyleCrossRef" href="#bib21">21</a>The current analysis provides other important results that will be helpful in conducting future studies. First, the modified Duke criteria for definite endocarditis seemed to underestimate the presence of IE in this study. These findings highlight the difficulty in predicting IE in patients presenting with SAB using the Duke criteria alone. Careful and frequent clinical examination, follow-up blood cultures, and repeat TEE are additional measures that can be used to better define IE in patients at high risk for IE.Relatively low overall success rates in our patient population were also shown. Success rates in patients with RIE 6 weeks after the end of therapy were comparable in both study arms (42% for daptomycin and 44% for comparator) but were lower than previously reported.<a class="elsevierStyleCrossRefs" href="#bib22">22,23</a> These low rates can be partially attributed to the strict criteria used to define treatment success. For example, when considering only patients in whom treatment was ineffective (i.e., patients who died or experienced clinical or microbiological failure), clinical success rates were higher (63% for daptomycin and 69% for the comparator) and consistent with the rates reported in the literature.<a class="elsevierStyleCrossRef" href="#bib22">22</a>Patients with LIE fared much worse than patients with RIE, regardless of the treatment received. A final diagnosis of LIE was associated with poor overall success, low rates of clinical success, and lower survival in both treatment groups. Although RIE is usually associated with a favorable outcome,<a class="elsevierStyleCrossRefs" href="#bib24">24,25</a> LIE is a disease of high morbidity and mortality rates. Patients with S. aureus LIE are older and have more comorbidities than patients with S. aureus RIE. They also have a higher likelihood of heart failure, embolization to the central nervous system, and in-hospital death.<a class="elsevierStyleCrossRef" href="#bib20">20</a> Patients with LIE in this trial had serious complications, including stroke, osteomyelitis, valve perforation, and intracardiac abscesses. Only 1 of 18 patients with LIE in this trial underwent valve surgery while undergoing therapy; it is likely this contributed to the low success rates. In a retrospective study of 513 adult patients with complicated native-valve LIE, medical therapy alone was associated with a 2.12-fold risk for death at 6 months, compared with medical therapy with adjunctive valve surgery.<a class="elsevierStyleCrossRef" href="#bib26">26</a> A recent prospective analysis in patients with IE identified surgical therapy as a factor associated with a significant reduction in mortality rate (adjusted hazard ratio 0.27, 95% confidence interval [CI] 0.13–0.55).<a class="elsevierStyleCrossRef" href="#bib27">27</a>S. aureus is an important cause of bloodstream infections with different clinical courses and outcomes, ranging from uncomplicated bacteremia to potentially life-threatening LIE. Molecular analysis of isolates causing infections at the ends of the spectrum of disease severity (LIE vs uncomplicated bacteremia) did not reveal any differences in the virulence genes that promote the infection.This analysis has several limitations. First, it is a subgroup analysis, in which potential for overinterpretation exists.<a class="elsevierStyleCrossRef" href="#bib28">28</a> However, the results have been presented with no inference of statistical significance between the study arms. Second, the sample size is small. Therefore, additional studies are necessary, especially in patients with LIE, who were not originally considered for enrollment. Finally, the open-label nature of the trial constitutes a source of bias because investigators were allowed to initiate and discontinue treatment according to their clinical judgment. However, the potential for bias was minimized by using independent echocardiographers and an independent adjudication committee, all of whom were blind to treatment assignment.In conclusion, our results suggest that daptomycin at 6mg/kg/day is an efficacious and well tolerated treatment option in patients with S. aureus native-valve RIE.Conflict of interest statementKanafani: no competing interest declared.Boucher: advisor consultant to Basilea, Cubist, Johnson & Johnson, Merck, Novartis, Pfizer, Targanta, Astellas/Theravance; speaker for Cubist, Novartis; owns shares of Cubist and Pfizer.Fowler: grant/research support from Cubist, Cerexa, Merck, Theravance, Inhibitex, Nabi, NIH; paid consultant to Cubist, Inhibitex, Leo Pharm, Merck, Johnson & Johnson; on the speaker's bureau for Cubist; received honoraria from Arpida, Astellas, Cubist, Inhibitex, Merck, Theravance, Ortho-McNeil; member on advisory committee of Cubist.Cabell: no competing interest declared.Hoen: no competing interest declared.Miro: medical school grants/honoraria for speaking or advisory boards of BMS, Cubist, Novartis, Theravance, Merck, Gilead, GSK.Lalani: no competing interest declared.Vigliani: employee of Cubist during conduct of study and analysis of results.Campion: paid consultant to Cubist; owns stocks in Cubist.Corey: consultant for Cubist.Levine: on the speaker's bureau for Cubist; research support from Cubist." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres263972" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Methods" 3 => "Results" 4 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec247379" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres263971" "titulo" => array:5 [ 0 => "Resumen" 1 => "Introducción" 2 => "Métodos" 3 => "Resultados" 4 => "Conclusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec247378" "titulo" => "Palabras clave" ] 4 => array:1 [ "titulo" => "Introduction" ] 5 => array:2 [ "titulo" => "Methods" "secciones" => array:5 [ 0 => array:1 [ "titulo" => "Study design and patients" ] 1 => array:1 [ "titulo" => "Randomization, treatments, and outcomes" ] 2 => array:1 [ "titulo" => "Entry and final diagnoses and duration of therapy" ] 3 => array:1 [ "titulo" => "Molecular analysis" ] 4 => array:1 [ "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "titulo" => "Results" "secciones" => array:6 [ 0 => array:1 [ "titulo" => "Study population" ] 1 => array:1 [ "titulo" => "Outcomes of patients with RIE" ] 2 => array:1 [ "titulo" => "Outcomes of patients with LIE" ] 3 => array:1 [ "titulo" => "Treatment failure" ] 4 => array:1 [ "titulo" => "Safety" ] 5 => array:1 [ "titulo" => "Microbiological and molecular analysis" ] ] ] 7 => array:1 [ "titulo" => "Discussion" ] 8 => array:1 [ "titulo" => "Conflict of interest statement" ] 9 => array:2 [ "identificador" => "xack58661" "titulo" => "Acknowledgments" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-05-22" "fechaAceptado" => "2009-07-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec247379" "palabras" => array:3 [ 0 => "Staphylococcus aureus" 1 => "Daptomycin" 2 => "Endocarditis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec247378" "palabras" => array:3 [ 0 => "Staphylococcus aureus" 1 => "Daptomicina" 2 => "Endocarditis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "IntroductionIn a recent randomized trial of Staphylococcus aureus bacteremia and native valve endocarditis, daptomycin was found not inferior to standard therapy. We summarized findings in the subgroup of patients with endocarditis according to the Duke criteria. MethodsPatients were randomly assigned to receive daptomycin 6mg/kg/day or standard therapy (vancomycin 1g every 12h or antistaphylococcal penicillin 2g every 4h, both with gentamicin 1mg/kg every 8h for the first 4 days). The primary end point was success in the modified intent-to-treat population 6 weeks after the end of therapy. ResultsFifty-three patients were included: 35 with right-sided endocarditis (RIE) and 18 with left-sided endocarditis (LIE). The success rates in patients with RIE were similar between daptomycin and the comparator (42% vs 44%). Patients with RIE with septic pulmonary infarcts responded similarly to treatment with daptomycin and standard therapy (60% vs 67%). In the LIE population, treatment success rates were poor in both arms (11% vs 22%). ConclusionDaptomycin is an efficacious and well-tolerated alternative to standard therapy in the treatment of RIE. Patients with LIE had a poor outcome regardless of the treatment received. Daptomycin is also effective in treating endocarditis with septic pulmonary infarcts." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "IntroducciónEn un reciente ensayo aleatorizado sobre bacteriemia por Staphylococcus aureus y endocarditis de la válvula natural, daptomicina no resultó inferior a la terapéutica estándar. Resumimos los hallazgos en el subgrupo de pacientes con endocarditis según los criterios de Duke. MétodosLos pacientes fueron asignados aleatoriamente a recibir daptomicina, 6mg/kg/día, o la terapéutica estándar (vancomicina 1g cada 12h o una penicilina antiestafilocócica 2g cada 4h, ambos con gentamicina 1mg/kg cada 8h, durante los 4 primeros días). La variable principal fue el éxito en la población modificada por intención de tratamiento 6 semanas después del final del tratamiento. ResultadosEl estudio incluyó a 53 pacientes: 35 con endocarditis infecciosa de las cavidades derechas (RIE) y 18 con endocarditis infecciosa de las cavidades izquierdas (LIE). En los pacientes con RIE, las tasas de éxito con daptomicina y el tratamiento de comparación fueron similares (42% frente a 44%). Los pacientes con RIE e infartos pulmonares sépticos respondieron de forma similar al tratamiento con daptomicina y con la terapéutica estándar (60% frente a 67%). En la población con LIE, las tasas de éxito fueron pobres con ambos brazos (11% frente a 22%). ConclusiónDaptomicina es una alternativa eficaz y bien tolerada a la terapéutica estándar en el tratamiento de la RIE. Los pacientes con LIE tuvieron mal resultado, con independencia del tratamiento recibido. Daptomicina también es eficaz en el tratamiento de la endocarditis con infartos pulmonares sépticos." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "BMI, body mass index; cRIE, complicated right-sided infective endocarditis; IE, infective endocarditis; LIE, left-sided infective endocarditis; MITT, modified intent-to-treat; MRSA, methicillin-resistant Staphylococcus aureus; SIRS, systemic inflammatory response syndrome; uRIE, uncomplicated right-sided infective endocarditis" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Characteristic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Daptomycin (n=28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Comparator (n=25) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (yrs), median (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (27–82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 (28–91) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male sex, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI (kg/m2), median (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (18–37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (19–39) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine clearance (mL/min), median (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 (47–173) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 (18–193) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Risk factor for endocarditis, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Injection drug use \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (56) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HIV infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prior endocarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preexisting valvular heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (16) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Percutaneous intravascular device \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Permanent intravascular foreign material \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (16) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Extravascular foreign material \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (12) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MRSA infection, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SIRS, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (84) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Entry diagnosis, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Definite endocarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (80) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Possible endocarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not endocarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Final diagnosis, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">uRIE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (16) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">cRIE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (48) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LIE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (36) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab372912.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of patients with IE in the MITT population based on treatment assignment" ] ] 1 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CI, confidence interval; MITT, modified intent-to-treat; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible Staphylococcus aureus; RIE, right-sided infective endocarditis." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Outcome measure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Daptomycin, n/N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Comparator, n/N (%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RIE</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall success \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8/19 (42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7/16 (44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[95% CI] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[20, 66] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[20, 70] \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in MRSA subgroup \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/8 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/7 (43) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in MSSA subgroup \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/11 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/9 (44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in patients with septic pulmonary emboli \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6/10 (60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6/9 (67) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in patients with uncomplicated right-sided endocarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/6 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/4 (25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in patients with complicated right-sided endocarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/13 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6/12 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical success \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12/19 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11/16 (69) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0/19 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/16 (12) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left-sided endocarditis</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall success \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/9 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/9 (22) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in MRSA subgroup \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0/5 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0/4 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in MSSA subgroup \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/4 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/5 (40) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Success in patients with septic pulmonary emboli \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0/3 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical success \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/9 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/9 (44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/9 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/9 (56) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab372913.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Outcome 6 weeks after completion of study medication in patients in the MITT population" ] ] 2 => array:7 [ "identificador" => "tbl3" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "S. aureus, Staphylococcus aureus." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reason for failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Daptomycin (n=28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Comparator (n=25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">n (%)</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persisting or relapsing S. aureus infection or clinical failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical failure without persisting or relapsing S. aureus infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patient died \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Discontinued due to adverse event \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-study antibiotics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No blood culture 6 weeks after end of therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-evaluable (e.g., withdrew consent) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall failure rates \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (56) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab372911.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn3ast" "etiqueta" => "*" "nota" => "More than 1 reasons may be indicated for each patient." ] ] ] "descripcion" => array:1 [ "en" => "Reasons for treatment failure according to the adjudication committee<a class="elsevierStyleCrossRef" href="#tblfn3ast">*</a>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcus aureus endocarditis: a consequence of medical progress" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V.G. Fowler Jr" 1 => "J.M. Miro" 2 => "B. Hoen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Med Assoc" "fecha" => "2005" "volumen" => "293" "paginaInicial" => "3012" "paginaFinal" => "3021" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for nosocomial infective endocarditis in patients with methicillin-resistant Staphylococcus aureus bacteremia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.B. Hsu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/502597" "Revista" => array:6 [ "tituloSerie" => "Infect Control Hosp Epidemiol" "fecha" => "2005" "volumen" => "26" "paginaInicial" => "654" "paginaFinal" => "657" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16092748" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increasing rates of cardiac device infections among Medicare beneficiaries: 1990–1999" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "C.H. Cabell" 1 => "P.A. Heidenreich" 2 => "V.H. Chu" 3 => "C.M. Moore" 4 => "M.E. Stryjewski" 5 => "G.R. Corey" 6 => "V.G. Fowler Jr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ahj.2003.06.005" "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "2004" "volumen" => "147" "paginaInicial" => "582" "paginaFinal" => "586" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15077071" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of infections associated with surgical implants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.O. Darouiche" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra035415" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2004" "volumen" => "350" "paginaInicial" => "1422" "paginaFinal" => "1429" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15070792" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nosocomial cardiac infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Giamarellou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/jhin.2001.1144" "Revista" => array:6 [ "tituloSerie" => "J Hosp Infect" "fecha" => "2002" "volumen" => "50" "paginaInicial" => "91" "paginaFinal" => "105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11846535" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcus aureus bacteremia and endocarditis. New diagnostic and therapeutic concepts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L.A. Mortara" 1 => "A.S. Bayer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Infect Dis Clin North Am" "fecha" => "1993" "volumen" => "7" "paginaInicial" => "53" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8463653" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The changing clinical aspects of infective endocarditis: descriptive review of 90 episodes in a French teaching hospital and risk factors for death" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Mouly" 1 => "R. Ruimy" 2 => "O. Launay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Infect" "fecha" => "2002" "volumen" => "45" "paginaInicial" => "246" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12423613" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hospital-acquired infective endocarditis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.S. Terpenning" 1 => "B.P. Buggy" 2 => "C.A. Kauffman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1988" "volumen" => "148" "paginaInicial" => "1601" "paginaFinal" => "1603" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3382305" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T.S. Naimi" 1 => "K.H. LeDell" 2 => "K. Como-Sabetti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Med Assoc" "fecha" => "2003" "volumen" => "290" "paginaInicial" => "2976" "paginaFinal" => "2984" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Wisplinghoff" 1 => "T. Bischoff" 2 => "S.M. Tallent" 3 => "H. Seifert" 4 => "R.P. Wenzel" 5 => "M.B. Edmond" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/421946" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2004" "volumen" => "39" "paginaInicial" => "309" "paginaFinal" => "317" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15306996" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical failure of vancomycin treatment of Staphylococcus aureus infection in a tertiary care hospital in southern Brazil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Lutz" 1 => "A. Machado" 2 => "N. Kuplich" 3 => "A.L. Barth" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Braz J Infect Dis" "fecha" => "2003" "volumen" => "7" "paginaInicial" => "224" "paginaFinal" => "228" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14499046" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased vancomycin MICs for Staphylococcus aureus clinical isolates from a university hospital during a 5-year period" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Wang" 1 => "J.F. Hindler" 2 => "K.W. Ward" 3 => "D.A. Bruckner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.01388-06" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2006" "volumen" => "44" "paginaInicial" => "3883" "paginaFinal" => "3886" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16957043" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vancomycin treatment failures in Staphylococcus aureus lower respiratory tract infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.A. Moise" 1 => "J.J. Schentag" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Int J Antimicrob Agents" "fecha" => "2000" "volumen" => "16" "numero" => "Suppl. 1" "paginaInicial" => "S31" "paginaFinal" => "S34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11137406" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship of MIC and bactericidal activity to efficacy of vancomycin for treatment of methicillin-resistant Staphylococcus aureus bacteremia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Sakoulas" 1 => "P.A. Moise-Broder" 2 => "J. Schentag" 3 => "A. Forrest" 4 => "R.C. Moellering Jr" 5 => "G.M. Eliopoulos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.42.6.2398-2402.2004" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2004" "volumen" => "42" "paginaInicial" => "2398" "paginaFinal" => "2402" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15184410" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Activity of daptomycin against susceptible and multidrug-resistant Gram-positive pathogens collected in the SECURE study (Europe) during 2000–2001" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I.A. Critchley" 1 => "D.C. Draghi" 2 => "D.F. Sahm" 3 => "C. Thornsberry" 4 => "M.E. Jones" 5 => "J.A. Karlowsky" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2003" "volumen" => "51" "paginaInicial" => "639" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12615866" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1699258X0572711X" "estado" => "S300" "issn" => "1699258X" ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The safety and efficacy of daptomycin for the treatment of complicated skin and skin-structure infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.D. Arbeit" 1 => "D. Maki" 2 => "F.P. Tally" 3 => "E. Campanaro" 4 => "B.I. Eisenstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/420818" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2004" "volumen" => "38" "paginaInicial" => "1673" "paginaFinal" => "1681" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15227611" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V.G. Fowler Jr" 1 => "H.W. Boucher" 2 => "G.R. Corey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa053783" "Revista" => array:7 [ "tituloSerie" => "N Engl J Med" "fecha" => "2006" "volumen" => "355" "paginaInicial" => "653" "paginaFinal" => "665" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16914701" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109705007631" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.S. Li" 1 => "D.J. Sexton" 2 => "N. Mick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/313753" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2000" "volumen" => "30" "paginaInicial" => "633" "paginaFinal" => "638" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10770721" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genotypic characteristics of Staphylococcus aureus isolates from a multinational trial of complicated skin and skin structure infections" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.J. Campbell" 1 => "H.S. Deshmukh" 2 => "C.L. Nelson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.01822-07" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2008" "volumen" => "46" "paginaInicial" => "678" "paginaFinal" => "684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18077636" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcus aureus native valve infective endocarditis: report of 566 episodes from the International Collaboration on Endocarditis Merged Database" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.M. Miro" 1 => "I. Anguera" 2 => "C.H. Cabell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/431979" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2005" "volumen" => "41" "paginaInicial" => "507" "paginaFinal" => "514" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16028160" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inhibition of daptomycin by pulmonary surfactant: in vitro modeling and clinical impact" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.A. Silverman" 1 => "L.I. Mortin" 2 => "A.D. Vanpraagh" 3 => "T. Li" 4 => "J. Alder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/430352" "Revista" => array:6 [ "tituloSerie" => "J Infect Dis" "fecha" => "2005" "volumen" => "191" "paginaInicial" => "2149" "paginaFinal" => "2152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15898002" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combination antimicrobial therapy for Staphylococcus aureus endocarditis in patients addicted to parenteral drugs and in nonaddicts: a prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Korzeniowski" 1 => "M.A. Sande" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1982" "volumen" => "97" "paginaInicial" => "496" "paginaFinal" => "503" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6751182" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effectiveness of cloxacillin with and without gentamicin in short-term therapy for right-sided Staphylococcus aureus endocarditis. A randomized, controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Ribera" 1 => "J. Gomez-Jimenez" 2 => "E. Cortes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1996" "volumen" => "125" "paginaInicial" => "969" "paginaFinal" => "974" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8967707" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Results of surgical treatment for infective endocarditis in intravenous drug users" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Mathew" 1 => "G. Abreo" 2 => "K. Namburi" 3 => "L. Narra" 4 => "C. Franklin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1995" "volumen" => "108" "paginaInicial" => "73" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7606996" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features, site of involvement, bacteriologic findings, and outcome of infective endocarditis in intravenous drug users" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Mathew" 1 => "T. Addai" 2 => "A. Anand" 3 => "A. Morrobel" 4 => "P. Maheshwari" 5 => "S. Freels" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1995" "volumen" => "155" "paginaInicial" => "1641" "paginaFinal" => "1648" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7618988" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complicated left-sided native valve endocarditis in adults: risk classification for mortality" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Hasbun" 1 => "H.R. Vikram" 2 => "L.A. Barakat" 3 => "J. Buenconsejo" 4 => "V.J. Quagliarello" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Med Assoc" "fecha" => "2003" "volumen" => "289" "paginaInicial" => "1933" "paginaFinal" => "1940" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early surgery in patients with infective endocarditis: a propensity score analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "O. Aksoy" 1 => "D.J. Sexton" 2 => "A. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/510583" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2007" "volumen" => "44" "paginaInicial" => "364" "paginaFinal" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17205442" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The challenge of subgroup analyses—reporting without distorting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.W. Lagakos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMp068070" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2006" "volumen" => "354" "paginaInicial" => "1667" "paginaFinal" => "1669" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16625007" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack58661" "titulo" => "Acknowledgments" "texto" => "This work was funded by Cubist Pharmaceuticals. The funding agency was involved in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. This work was approved by the individual Institutional Review Boards at the participating study sites." ] ] ] "idiomaDefecto" => "en" "url" => "/0213005X/0000002800000008/v2_201308271925/S0213005X1000042X/v2_201308271925/en/main.assets" "Apartado" => array:4 [ "identificador" => "8693" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/0213005X/0000002800000008/v2_201308271925/S0213005X1000042X/v2_201308271925/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X1000042X?idApp=UINPBA00004N"]

Statistics

Original

Daptomycin compared to standard therapy for the treatment of native valve endocarditis

Comparación entre daptomicina y la terapéutica estándar en el tratamiento de la endocarditis de la válvula natural

Zeina Kanafania, Helen Boucherb, Vance Fowlerc,d, Christopher Cabellc,d, Bruno Hoene, José M. Miróf, Tahaniyat Lalanic,d, Gloria Viglianig, Marilyn Campiong, Ralph Coreyc,d, Donald Levineh,

Corresponding author

DLevine@med.wayne.edu

Corresponding author.

a American University of Beirut Medical Center, Beirut, Líbano

b Tufts New England Medical Center, Boston, MA, Estados Unidos

c Duke University Medical Center, NC, Estados Unidos

d Duke Clinical Research Institute, Durham, NC, Estados Unidos

e Hôpital Saint-Jacques, Besançon, Francia

f Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, España

g Newton, MA, Estados Unidos

h Wayne State University School of Medicine, Detroit, MI, Estados Unidos

Read

7862

Times
was read the article

1826

Total PDF

6036

Total HTML

Share statistics

 array:23 [
  "pii" => "S0213005X1000042X"
  "issn" => "0213005X"
  "doi" => "10.1016/j.eimc.2009.07.015"
  "estado" => "S300"
  "fechaPublicacion" => "2010-10-01"
  "aid" => "270"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;. All rights reserved"
  "copyrightAnyo" => "2009"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Enferm Infecc Microbiol Clin. 2010;28:498-503"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 4950
    "formatos" => array:3 [
      "EPUB" => 15
      "HTML" => 4003
      "PDF" => 932
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0213005X10000078"
    "issn" => "0213005X"
    "doi" => "10.1016/j.eimc.2009.09.009"
    "estado" => "S300"
    "fechaPublicacion" => "2010-10-01"
    "aid" => "267"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Enferm Infecc Microbiol Clin. 2010;28:504-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 5301
      "formatos" => array:3 [
        "EPUB" => 14
        "HTML" => 4628
        "PDF" => 659
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Peripheral facial palsy after varicella&#46; Report of two cases and review of the literature"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "504"
          "paginaFinal" => "508"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Par&#225;lisis facial perif&#233;rica posvaricela&#46; Descripci&#243;n de dos casos y revisi&#243;n de la literatura"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Montserrat Mu&#241;oz-Sellart, Carolina Garc&#237;a-Vidal, Sergio Mart&#237;nez-Yelamos, Jordi Niub&#243;, Pedro Fern&#225;ndez-Viladrich"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Montserrat"
              "apellidos" => "Mu&#241;oz-Sellart"
            ]
            1 => array:2 [
              "nombre" => "Carolina"
              "apellidos" => "Garc&#237;a-Vidal"
            ]
            2 => array:2 [
              "nombre" => "Sergio"
              "apellidos" => "Mart&#237;nez-Yelamos"
            ]
            3 => array:2 [
              "nombre" => "Jordi"
              "apellidos" => "Niub&#243;"
            ]
            4 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Fern&#225;ndez-Viladrich"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X10000078?idApp=UINPBA00004N"
    "url" => "/0213005X/0000002800000008/v2_201308271925/S0213005X10000078/v2_201308271925/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0213005X10000789"
    "issn" => "0213005X"
    "doi" => "10.1016/j.eimc.2009.12.009"
    "estado" => "S300"
    "fechaPublicacion" => "2010-10-01"
    "aid" => "289"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Enferm Infecc Microbiol Clin. 2010;28:492-7"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 9103
      "formatos" => array:3 [
        "EPUB" => 10
        "HTML" => 7594
        "PDF" => 1499
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Identificaci&#243;n bacteriana mediante espectrometr&#237;a de masas <span class="elsevierStyleItalic">matrix-assisted laser desorption ionization time-of-flight</span>&#46; Comparaci&#243;n con la metodolog&#237;a habitual en los laboratorios de Microbiolog&#237;a Cl&#237;nica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "492"
          "paginaFinal" => "497"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Identifying bacteria using a matrix-assisted laser desorption ionization time-of-flight &#40;MALDI-TOF&#41; mass spectrometer&#46; Comparison with routine methods used in clinical microbiology laboratories"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig1"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2600
              "Ancho" => 1636
              "Tamanyo" => 213629
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p class="elsevierStyleSimplePara elsevierViewall">A&#41; Comparaci&#243;n del perfil de un aislamiento cl&#237;nico de <span class="elsevierStyleItalic">Escherichia coli</span> con los recogidos en la base de datos Biotyper 2&#46;0&#46; B&#41; Comparaci&#243;n del perfil de un aislamiento cl&#237;nico de <span class="elsevierStyleItalic">Staphylococcus aureus</span> con los recogidos en la base de datos Biotyper 2&#46;0&#46; Aparecen en azul los perfiles de referencia de la base de datos&#44; en verde los picos de la cepa cl&#237;nica coincidentes con &#233;stos&#44; en amarillo los de coincidencia moderada y en rojo los no coincidentes&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Laura Ferreira, Silvia Vega, Fernando S&#225;nchez-Juanes, Magdalena Gonz&#225;lez, Ana Herrero, M<span class="elsevierStyleSup">a</span> Carmen Mu&#241;iz, Jos&#233; Manuel Gonz&#225;lez-Buitrago, Juan Luis Mu&#241;oz"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Ferreira"
            ]
            1 => array:2 [
              "nombre" => "Silvia"
              "apellidos" => "Vega"
            ]
            2 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "S&#225;nchez-Juanes"
            ]
            3 => array:2 [
              "nombre" => "Magdalena"
              "apellidos" => "Gonz&#225;lez"
            ]
            4 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Herrero"
            ]
            5 => array:2 [
              "nombre" => "M<span class="elsevierStyleSup">a</span> Carmen"
              "apellidos" => "Mu&#241;iz"
            ]
            6 => array:3 [
              "Iniciales" => "J.M."
              "nombre" => "Jos&#233; Manuel"
              "apellidos" => "Gonz&#225;lez-Buitrago"
            ]
            7 => array:2 [
              "nombre" => "Juan Luis"
              "apellidos" => "Mu&#241;oz"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X10000789?idApp=UINPBA00004N"
    "url" => "/0213005X/0000002800000008/v2_201308271925/S0213005X10000789/v2_201308271925/es/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Daptomycin compared to standard therapy for the treatment of native valve endocarditis"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "498"
        "paginaFinal" => "503"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Zeina Kanafani, Helen Boucher, Vance Fowler, Christopher Cabell, Bruno Hoen, Jos&#233; M&#46; Mir&#243;, Tahaniyat Lalani, Gloria Vigliani, Marilyn Campion, Ralph Corey, Donald Levine"
        "autores" => array:11 [
          0 => array:3 [
            "nombre" => "Zeina"
            "apellidos" => "Kanafani"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Helen"
            "apellidos" => "Boucher"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Vance"
            "apellidos" => "Fowler"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Christopher"
            "apellidos" => "Cabell"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Bruno"
            "apellidos" => "Hoen"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff5"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Jos&#233;"
            "apellidos" => "M&#46; Mir&#243;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff6"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Tahaniyat"
            "apellidos" => "Lalani"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Gloria"
            "apellidos" => "Vigliani"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff7"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Marilyn"
            "apellidos" => "Campion"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff7"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Ralph"
            "apellidos" => "Corey"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          10 => array:4 [
            "nombre" => "Donald"
            "apellidos" => "Levine"
            "email" => array:1 [
              0 => "DLevine&#64;med&#46;wayne&#46;edu"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff8"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:8 [
          0 => array:3 [
            "entidad" => "American University of Beirut Medical Center&#44; Beirut&#44; L&#237;bano"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Tufts New England Medical Center&#44; Boston&#44; MA&#44; Estados Unidos"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Duke University Medical Center&#44; NC&#44; Estados Unidos"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
          3 => array:3 [
            "entidad" => "Duke Clinical Research Institute&#44; Durham&#44; NC&#44; Estados Unidos"
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "aff4"
          ]
          4 => array:3 [
            "entidad" => "H&#244;pital Saint-Jacques&#44; Besan&#231;on&#44; Francia"
            "etiqueta" => "<span class="elsevierStyleSup">e</span>"
            "identificador" => "aff5"
          ]
          5 => array:3 [
            "entidad" => "Hospital Clinic-IDIBAPS&#44; University of Barcelona&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">f</span>"
            "identificador" => "aff6"
          ]
          6 => array:3 [
            "entidad" => "Newton&#44; MA&#44; Estados Unidos"
            "etiqueta" => "<span class="elsevierStyleSup">g</span>"
            "identificador" => "aff7"
          ]
          7 => array:3 [
            "entidad" => "Wayne State University School of Medicine&#44; Detroit&#44; MI&#44; Estados Unidos"
            "etiqueta" => "<span class="elsevierStyleSup">h</span>"
            "identificador" => "aff8"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Comparaci&#243;n entre daptomicina y la terap&#233;utica est&#225;ndar en el tratamiento de la endocarditis de la v&#225;lvula natural"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStylePara elsevierViewall">Important changes have occurred in recent years in the epidemiology of infective endocarditis &#40;IE&#41; caused by <span class="elsevierStyleItalic">Staphylococcus aureus</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1&#44;2</span></a> The observed increase in the incidence of the disease can be ascribed to the increase in frequency and complexity of invasive medical procedures performed on seriously ill patients with significant comorbidities&#46;<a class="elsevierStyleCrossRefs" href="#bib3"><span class="elsevierStyleSup">3&#44;4</span></a> Therefore&#44; <span class="elsevierStyleItalic">S&#46; aureus</span> endocarditis is currently a disease of elderly&#44; debilitated&#44; and hospitalized patients&#44; in addition to the traditional&#44; relatively healthy&#44; injection drug abusers&#46;<a class="elsevierStyleCrossRefs" href="#bib5"><span class="elsevierStyleSup">5&#8211;8</span></a> Also&#44; as part of the global shift in the antimicrobial resistance pattern of <span class="elsevierStyleItalic">S&#46; aureus</span>&#44; more methicillin-resistant <span class="elsevierStyleItalic">S&#46; aureus</span> &#40;MRSA&#41; strains are causing bacteremia and endocarditis&#44; thereby contributing to the challenging nature of the problem&#46;<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;10</span></a></p><p class="elsevierStylePara elsevierViewall">The use of glycopeptides for the treatment of <span class="elsevierStyleItalic">S&#46; aureus</span> endocarditis has been fraught with problems&#46; Vancomycin-intermediate <span class="elsevierStyleItalic">S&#46; aureus</span> isolates and heteroresistant strains have been increasingly reported&#46;<a class="elsevierStyleCrossRefs" href="#bib11"><span class="elsevierStyleSup">11&#44;12</span></a> Treatment failure with vancomycin has been described even when the minimum inhibitory concentrations &#40;MICs&#41; are well within the susceptible range &#40;1&#8211;2<span class="elsevierStyleHsp" style=""></span>mg&#47;mL&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib13"><span class="elsevierStyleSup">13&#44;14</span></a> Alternative treatment strategies for MRSA are&#44; therefore&#44; needed&#46;</p><p class="elsevierStylePara elsevierViewall">Daptomycin is a lipopeptide agent with rapid bactericidal activity against <span class="elsevierStyleItalic">S&#46; aureus</span>&#46;<a class="elsevierStyleCrossRef" href="#bib15"><span class="elsevierStyleSup">15</span></a> It is approved for the treatment of complicated skin and skin-structure infections at a dose of 4<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#46;<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> In an international&#44; prospective&#44; randomized trial of daptomycin vs standard therapy for <span class="elsevierStyleItalic">S&#46; aureus</span> bacteremia &#40;SAB&#41;<a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a> and <span class="elsevierStyleItalic">S&#46; aureus</span> infective endocarditis&#44; daptomycin was effective and less nephrotoxic than the comparator&#46;<a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> It was subsequently approved for treatment of <span class="elsevierStyleItalic">S&#46; aureus</span> bacteremia &#40;SAB&#41; and right-sided endocarditis &#40;RIE&#41; at a dose of 6<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#46; Here we summarize the experience with IE in that trial&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Study design and patients</span><p class="elsevierStylePara elsevierViewall">This was an open-label&#44; randomized&#44; active-control study conducted between August 28&#44; 2002&#44; and February 16&#44; 2005&#44; in 44 sites in the United States and Western Europe&#46; Patients were considered for enrollment in the study if they were at least 18 years of age and had at least 1 blood culture that was positive for <span class="elsevierStyleItalic">S&#46; aureus</span> within 2 calendar days of initiating the study medication&#46; Exclusion criteria included creatinine clearance less than 30<span class="elsevierStyleHsp" style=""></span>mL&#47;min and known osteomyelitis&#44; polymicrobial bacteremia&#44; or pneumonia&#46; For a full list of the exclusion criteria&#44; please refer to the initial publication&#46;<a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> In the initial phases of the trial&#44; patients with left-sided endocarditis &#40;LIE&#41; were excluded&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Randomization&#44; treatments&#44; and outcomes</span><p class="elsevierStylePara elsevierViewall">Eligible patients were randomly assigned to receive either daptomycin &#40;CUBICIN<span class="elsevierStyleSup">&#174;</span>&#44; Cubist Pharmaceuticals&#41; at 6<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day or standard therapy&#44; with either 1<span class="elsevierStyleHsp" style=""></span>g vancomycin every 12<span class="elsevierStyleHsp" style=""></span>h &#40;for MRSA isolates&#41; or 2<span class="elsevierStyleHsp" style=""></span>g antistaphylococcal penicillin every 4<span class="elsevierStyleHsp" style=""></span>h &#40;for methicillin-susceptible <span class="elsevierStyleItalic">S&#46; aureus</span> &#91;MSSA&#93; isolates&#41;&#46; The duration of treatment was determined by the investigators based on the working diagnosis&#46; All patients who had a high likelihood of LIE at randomization were randomly assigned to receive daptomycin&#44; and all patients randomly assigned to receive standard therapy&#44; also received 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg gentamicin every 8<span class="elsevierStyleHsp" style=""></span>h for the first 4 days&#46; All patients underwent transesophageal echocardiography &#40;TEE&#41; within 5 days of enrollment&#44; as well as any necessary follow-up echocardiography&#46; Additionally&#44; all patients underwent diagnostic evaluation for metastatic foci of infection&#46;</p><p class="elsevierStylePara elsevierViewall">The primary efficacy measure was the success rate in the modified intent-to-treat &#40;MITT&#41; population 6 weeks after the end of therapy&#46; An independent external adjudication committee blinded to therapy&#44; consisting of 5 infectious diseases experts&#44; reviewed individual patient data to establish final diagnoses and outcomes&#46; Overall success was defined as survival&#44; clinical cure or improvement&#44; and a documented clearance of bacteremia&#46; In addition&#44; patients who did not complete adequate therapy&#44; who received potentially effective non-study antibiotics&#44; or who did not have blood cultures taken 6 weeks after completion of therapy were considered &#8220;treatment failures&#46;&#8221; In this analysis&#44; we also describe clinical success based on the presence of all of the following criteria&#58; survival&#44; clinical outcome of cure or improvement&#44; and resolution of <span class="elsevierStyleItalic">S&#46; aureus</span> infection 6 weeks after the end of therapy&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Entry and final diagnoses and duration of therapy</span><p class="elsevierStylePara elsevierViewall">Entry diagnoses were determined according to the modified Duke University criteria for IE&#46;<a class="elsevierStyleCrossRef" href="#bib18"><span class="elsevierStyleSup">18</span></a> Final diagnoses were based on standard clinical definitions&#46; Uncomplicated RIE &#40;uRIE&#41; was defined as definite or possible MSSA endocarditis in the absence of predisposing abnormalities or active infection of the mitral or aortic valve in a patient who actively uses injection drugs&#44; has a serum creatinine level of less than 2&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; and has no evidence of extrapulmonary sites of infection&#46; Minimum duration of therapy for patients with uRIE ranged from 14 to 28 days&#46; Complicated RIE &#40;cRIE&#41; was similarly defined&#44; but patients also had extrapulmonary sites of infection&#44; a serum creatinine level of at least 2&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; or MRSA bacteremia&#44; or did not use injection drugs&#46; Patients with cRIE received a minimum of 28&#8211;42 days of therapy&#46; Patients with LIE were treated for a minimum 28&#8211;42 days&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Molecular analysis</span><p class="elsevierStylePara elsevierViewall">In order to evaluate differences in the genotypic profiles of <span class="elsevierStyleItalic">S&#46; aureus</span> isolates causing infections of variable severity&#44; we compared <span class="elsevierStyleItalic">S&#46; aureus</span> isolates causing LIE &#40;usually the most serious infection&#41; with those causing uncomplicated bacteremia &#40;least serious infection&#41;&#46; Pulsed-field gel electrophoresis &#40;PFGE&#41; on these isolates was performed as previously described&#46;<a class="elsevierStyleCrossRef" href="#bib19"><span class="elsevierStyleSup">19</span></a> In addition&#44; and following previously reported methodology&#44;<a class="elsevierStyleCrossRef" href="#bib19"><span class="elsevierStyleSup">19</span></a> DNA extraction and polymerase chain reaction &#40;PCR&#41; assays were used to examine 33 bacterial determinants&#44; including toxins&#44; adhesins&#44; <span class="elsevierStyleItalic">agr</span> groups I&#8211;IV&#44; staphylococcal cassette chromosome <span class="elsevierStyleItalic">mec</span> &#40;SCC<span class="elsevierStyleItalic">mec</span>&#41; types I&#8211;IV&#44; as well as other virulence genes&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p class="elsevierStylePara elsevierViewall">Because of the limited number of patients in each arm&#44; only descriptive statistics were performed for this subgroup analysis&#46;</p></span></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Study population</span><p class="elsevierStylePara elsevierViewall">Of the 235 patients included in the MITT population in the original study&#44; 181 were thought to have definite or possible endocarditis on enrollment&#44; according to the modified Duke criteria for IE&#46; A total of 53 patients received a final diagnosis of IE&#46; All 37 patients who fulfilled the Duke criteria for definite endocarditis at enrollment had IE as the final diagnosis&#46; Of the 144 patients with possible endocarditis according to the Duke criteria&#44; 15 &#40;10&#37;&#41; had a final diagnosis of IE&#46; An additional patient was initially classified in the group without endocarditis&#44; but was subsequently found to have IE&#46;</p><p class="elsevierStylePara elsevierViewall">Of the 53 patients with a final diagnosis of endocarditis&#44; 28 were randomly assigned to receive daptomycin and 25 were randomly assigned to standard therapy&#46; There were no major differences between the study arms with regard to baseline patient characteristics&#44; risk factors for endocarditis&#44; entry diagnoses&#44; or final diagnoses &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a><span class="elsevierStyleBold">&#41;&#46;</span> The most common type of IE in both groups was cRIE &#40;25 patients&#44; 47&#37;&#41;&#44; followed by LIE &#40;18 patients&#44; 34&#37;&#41; and uRIE &#40;10 patients&#44; 19&#37;&#41;&#46; The proportion of patients with MRSA IE was similar in both groups &#40;46&#37; for daptomycin vs 44&#37; for the comparator&#41;&#46; Clinical evidence of systemic inflammatory response syndrome was present in 22 patients treated with daptomycin &#40;79&#37;&#41; and in 21 patients treated with standard therapy &#40;84&#37;&#41;&#46; Sixteen patients randomly assigned to receive daptomycin completed the course of therapy and received a median of 27 days of treatment&#46; In the comparator arm&#44; 14 patients completed the course of therapy and received a median of 30 days of antibiotic treatment&#46; Gentamicin was administered as study medication for 4 days to 1 patient in the daptomycin group and for a median of 5 days to all 25 patients in the comparator group&#46; Twenty-two patients with IE &#40;41&#37;&#41; received a diagnosis of septic pulmonary infarct during the first 5 days of the study &#40;10 in the daptomycin arm and 12 in the comparator arm&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Outcomes of patients with RIE</span><p class="elsevierStylePara elsevierViewall">In the MITT population&#44; the overall success rates for patients with RIE treated with daptomycin were similar to those of the comparator MITT population &#40;42&#37; vs 44&#37;&#59; <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46; Clinical success rates in this group of patients were higher in both arms &#40;63&#37; vs 69&#37;&#41;&#46; No difference in outcome was observed between the treatment groups of patients with MRSA or MSSA infection&#44; or in patients with septic pulmonary infarct&#46; Mortality rates were comparable for daptomycin and standard therapy &#40;0&#37; vs 12&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl2"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Outcomes of patients with LIE</span><p class="elsevierStylePara elsevierViewall">The overall success rates with LIE were poor in both arms &#40;11&#37; vs 22&#37;&#59; <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46; None of the 9 patients with LIE with MRSA infection had a successful outcome&#46; Mortality rates were 33&#37; with daptomycin treatment and 56&#37; with standard therapy&#46; Only 3 patients with LIE underwent valve surgery &#40;2 in the daptomycin arm&#44; 1 in the comparator arm&#41;&#58; 2 after treatment and 1 during treatment for IE&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Treatment failure</span><p class="elsevierStylePara elsevierViewall">The overall failure rates of daptomycin and standard therapy were comparable &#40;54&#37; vs 56&#37;&#59; <a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>&#41;&#46; The most common reason for failure in both study groups was persisting or relapsing <span class="elsevierStyleItalic">S&#46; aureus</span> infection or clinical failure &#40;29&#37; vs 28&#37;&#41;&#46; Patients receiving the comparator were more likely than those receiving daptomycin to experience treatment failure resulting from death&#44; adverse events &#40;AEs&#41;&#44; or receipt of potentially effective non-study antibiotics&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Safety</span><p class="elsevierStylePara elsevierViewall">Daptomycin was well tolerated&#46; The overall incidence of drug-related AEs was lower in the daptomycin arm &#40;32&#37; vs 50&#37;&#41;&#44; but the difference was not statistically significant &#40;<span class="elsevierStyleItalic">P</span>&#61;0&#46;27&#41;&#46; The proportion of patients in whom treatment was discontinued because of AEs was slightly lower with daptomycin &#40;21&#37;&#41; than with standard therapy &#40;31&#37;&#59; <span class="elsevierStyleItalic">P</span>&#61;0&#46;54&#41;&#46; Increases in creatine kinase levels &#40;&#62;500<span class="elsevierStyleHsp" style=""></span>IU&#47;L&#41; were noted in 12&#37; of patients taking daptomycin and in 4&#37; of those who received standard therapy &#40;<span class="elsevierStyleItalic">P</span>&#61;0&#46;61&#41;&#46; Conversely&#44; renal toxicity occurred in 21&#37; of patients in the comparator arm and in 15&#37; of patients in the daptomycin arm &#40;<span class="elsevierStyleItalic">P</span>&#61;0&#46;73&#41;&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Microbiological and molecular analysis</span><p class="elsevierStylePara elsevierViewall">The minimum inhibitory concentrations &#40;MICs&#41; of vancomycin and daptomycin were determined at baseline&#46; In both treatment arms&#44; the vancomycin MICs ranged between 0&#46;5 and 0&#46;1<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL while the daptomycin MICs ranged between 0&#46;12 and 0&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL&#46;</p><p class="elsevierStylePara elsevierViewall">Regarding molecular analysis&#44; no significant differences were seen in the distribution of virulence genes between the 2 groups of isolates &#40;those causing LIE and those causing uncomplicated bacteremia&#41;&#44; including toxins&#44; adhesins&#44; and other genes&#44; such as the <span class="elsevierStyleItalic">agr</span> gene complex&#46; In addition&#44; the <span class="elsevierStyleItalic">S&#46; aureus</span> isolates were similar with respect to SCC<span class="elsevierStyleItalic">mec</span> types&#44; PFGE types&#44; and antimicrobial susceptibility patterns&#46;</p></span></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStylePara elsevierViewall">In a large cohort of 2212 patients enrolled in the International Collaboration on Endocarditis-Merged Database &#40;ICE-MD&#41;&#44; <span class="elsevierStyleItalic">S&#46; aureus</span> was the most common pathogen in native-valve IE&#44; affecting 34&#37; of all patients with definite endocarditis&#46;<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a> More recent results from the ICE-Prospective Cohort Study &#40;ICE-PCS&#41; confirm that IE is most frequently caused by <span class="elsevierStyleItalic">S&#46; aureus</span> &#40;31&#37;&#59; of which 27&#37; are MRSA&#41;&#46; As health care-associated MRSA infection rates are rapidly rising&#44;<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a> there is growing concern about the continued use of vancomycin to treat serious and often life-threatening infections&#46; Because of increasing MICs&#44; identification of heteroresistant and vancomycin-intermediate <span class="elsevierStyleItalic">S&#46; aureus</span> isolates&#44; and clinical failures&#44;<a class="elsevierStyleCrossRefs" href="#bib12"><span class="elsevierStyleSup">12&#44;14</span></a> clinicians are searching for a new antistaphylococcal antibiotic&#46; The results of this subgroup analysis show that daptomycin is an effective alternative to standard therapy for treatment of RIE caused by <span class="elsevierStyleItalic">S&#46; aureus</span>&#46;</p><p class="elsevierStylePara elsevierViewall">We found that the success rates among patients with septic pulmonary emboli who received daptomycin were promising&#46; Although daptomycin is not indicated for the treatment of pneumonia due to drug inactivation by pulmonary surfactant&#44;<a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a> the findings in this study constitute important evidence that daptomycin is effective in treating septic pulmonary emboli concomitant with IE&#46; This can be explained because septic pulmonary emboli are&#44; by definition&#44; hematogenously spread and result in tissue infarction&#46; Therefore&#44; inactivation of daptomycin by surfactant should be less relevant than with lower respiratory tract infections&#46;<a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a></p><p class="elsevierStylePara elsevierViewall">The current analysis provides other important results that will be helpful in conducting future studies&#46; First&#44; the modified Duke criteria for definite endocarditis seemed to underestimate the presence of IE in this study&#46; These findings highlight the difficulty in predicting IE in patients presenting with SAB using the Duke criteria alone&#46; Careful and frequent clinical examination&#44; follow-up blood cultures&#44; and repeat TEE are additional measures that can be used to better define IE in patients at high risk for IE&#46;</p><p class="elsevierStylePara elsevierViewall">Relatively low overall success rates in our patient population were also shown&#46; Success rates in patients with RIE 6 weeks after the end of therapy were comparable in both study arms &#40;42&#37; for daptomycin and 44&#37; for comparator&#41; but were lower than previously reported&#46;<a class="elsevierStyleCrossRefs" href="#bib22"><span class="elsevierStyleSup">22&#44;23</span></a> These low rates can be partially attributed to the strict criteria used to define treatment success&#46; For example&#44; when considering only patients in whom treatment was ineffective &#40;i&#46;e&#46;&#44; patients who died or experienced clinical or microbiological failure&#41;&#44; clinical success rates were higher &#40;63&#37; for daptomycin and 69&#37; for the comparator&#41; and consistent with the rates reported in the literature&#46;<a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a></p><p class="elsevierStylePara elsevierViewall">Patients with LIE fared much worse than patients with RIE&#44; regardless of the treatment received&#46; A final diagnosis of LIE was associated with poor overall success&#44; low rates of clinical success&#44; and lower survival in both treatment groups&#46; Although RIE is usually associated with a favorable outcome&#44;<a class="elsevierStyleCrossRefs" href="#bib24"><span class="elsevierStyleSup">24&#44;25</span></a> LIE is a disease of high morbidity and mortality rates&#46; Patients with <span class="elsevierStyleItalic">S&#46; aureus</span> LIE are older and have more comorbidities than patients with <span class="elsevierStyleItalic">S&#46; aureus</span> RIE&#46; They also have a higher likelihood of heart failure&#44; embolization to the central nervous system&#44; and in-hospital death&#46;<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a> Patients with LIE in this trial had serious complications&#44; including stroke&#44; osteomyelitis&#44; valve perforation&#44; and intracardiac abscesses&#46; Only 1 of 18 patients with LIE in this trial underwent valve surgery while undergoing therapy&#59; it is likely this contributed to the low success rates&#46; In a retrospective study of 513 adult patients with complicated native-valve LIE&#44; medical therapy alone was associated with a 2&#46;12-fold risk for death at 6 months&#44; compared with medical therapy with adjunctive valve surgery&#46;<a class="elsevierStyleCrossRef" href="#bib26"><span class="elsevierStyleSup">26</span></a> A recent prospective analysis in patients with IE identified surgical therapy as a factor associated with a significant reduction in mortality rate &#40;adjusted hazard ratio 0&#46;27&#44; 95&#37; confidence interval &#91;CI&#93; 0&#46;13&#8211;0&#46;55&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib27"><span class="elsevierStyleSup">27</span></a></p><p class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">S&#46; aureus</span> is an important cause of bloodstream infections with different clinical courses and outcomes&#44; ranging from uncomplicated bacteremia to potentially life-threatening LIE&#46; Molecular analysis of isolates causing infections at the ends of the spectrum of disease severity &#40;LIE vs uncomplicated bacteremia&#41; did not reveal any differences in the virulence genes that promote the infection&#46;</p><p class="elsevierStylePara elsevierViewall">This analysis has several limitations&#46; First&#44; it is a subgroup analysis&#44; in which potential for overinterpretation exists&#46;<a class="elsevierStyleCrossRef" href="#bib28"><span class="elsevierStyleSup">28</span></a> However&#44; the results have been presented with no inference of statistical significance between the study arms&#46; Second&#44; the sample size is small&#46; Therefore&#44; additional studies are necessary&#44; especially in patients with LIE&#44; who were not originally considered for enrollment&#46; Finally&#44; the open-label nature of the trial constitutes a source of bias because investigators were allowed to initiate and discontinue treatment according to their clinical judgment&#46; However&#44; the potential for bias was minimized by using independent echocardiographers and an independent adjudication committee&#44; all of whom were blind to treatment assignment&#46;</p><p class="elsevierStylePara elsevierViewall">In conclusion&#44; our results suggest that daptomycin at 6<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day is an efficacious and well tolerated treatment option in patients with <span class="elsevierStyleItalic">S&#46; aureus</span> native-valve RIE&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest statement</span><p class="elsevierStylePara elsevierViewall">Kanafani&#58; no competing interest declared&#46;</p><p class="elsevierStylePara elsevierViewall">Boucher&#58; advisor consultant to Basilea&#44; Cubist&#44; Johnson &#38; Johnson&#44; Merck&#44; Novartis&#44; Pfizer&#44; Targanta&#44; Astellas&#47;Theravance&#59; speaker for Cubist&#44; Novartis&#59; owns shares of Cubist and Pfizer&#46;</p><p class="elsevierStylePara elsevierViewall">Fowler&#58; grant&#47;research support from Cubist&#44; Cerexa&#44; Merck&#44; Theravance&#44; Inhibitex&#44; Nabi&#44; NIH&#59; paid consultant to Cubist&#44; Inhibitex&#44; Leo Pharm&#44; Merck&#44; Johnson &#38; Johnson&#59; on the speaker&#39;s bureau for Cubist&#59; received honoraria from Arpida&#44; Astellas&#44; Cubist&#44; Inhibitex&#44; Merck&#44; Theravance&#44; Ortho-McNeil&#59; member on advisory committee of Cubist&#46;</p><p class="elsevierStylePara elsevierViewall">Cabell&#58; no competing interest declared&#46;</p><p class="elsevierStylePara elsevierViewall">Hoen&#58; no competing interest declared&#46;</p><p class="elsevierStylePara elsevierViewall">Miro&#58; medical school grants&#47;honoraria for speaking or advisory boards of BMS&#44; Cubist&#44; Novartis&#44; Theravance&#44; Merck&#44; Gilead&#44; GSK&#46;</p><p class="elsevierStylePara elsevierViewall">Lalani&#58; no competing interest declared&#46;</p><p class="elsevierStylePara elsevierViewall">Vigliani&#58; employee of Cubist during conduct of study and analysis of results&#46;</p><p class="elsevierStylePara elsevierViewall">Campion&#58; paid consultant to Cubist&#59; owns stocks in Cubist&#46;</p><p class="elsevierStylePara elsevierViewall">Corey&#58; consultant for Cubist&#46;</p><p class="elsevierStylePara elsevierViewall">Levine&#58; on the speaker&#39;s bureau for Cubist&#59; research support from Cubist&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:2 [
          "identificador" => "xres263972"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Introduction"
            2 => "Methods"
            3 => "Results"
            4 => "Conclusion"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec247379"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres263971"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Introducci&#243;n"
            2 => "M&#233;todos"
            3 => "Resultados"
            4 => "Conclusi&#243;n"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec247378"
          "titulo" => "Palabras clave"
        ]
        4 => array:1 [
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "titulo" => "Methods"
          "secciones" => array:5 [
            0 => array:1 [
              "titulo" => "Study design and patients"
            ]
            1 => array:1 [
              "titulo" => "Randomization&#44; treatments&#44; and outcomes"
            ]
            2 => array:1 [
              "titulo" => "Entry and final diagnoses and duration of therapy"
            ]
            3 => array:1 [
              "titulo" => "Molecular analysis"
            ]
            4 => array:1 [
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "titulo" => "Results"
          "secciones" => array:6 [
            0 => array:1 [
              "titulo" => "Study population"
            ]
            1 => array:1 [
              "titulo" => "Outcomes of patients with RIE"
            ]
            2 => array:1 [
              "titulo" => "Outcomes of patients with LIE"
            ]
            3 => array:1 [
              "titulo" => "Treatment failure"
            ]
            4 => array:1 [
              "titulo" => "Safety"
            ]
            5 => array:1 [
              "titulo" => "Microbiological and molecular analysis"
            ]
          ]
        ]
        7 => array:1 [
          "titulo" => "Discussion"
        ]
        8 => array:1 [
          "titulo" => "Conflict of interest statement"
        ]
        9 => array:2 [
          "identificador" => "xack58661"
          "titulo" => "Acknowledgments"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2009-05-22"
    "fechaAceptado" => "2009-07-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec247379"
          "palabras" => array:3 [
            0 => "<span class="elsevierStyleItalic">Staphylococcus aureus</span>"
            1 => "Daptomycin"
            2 => "Endocarditis"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec247378"
          "palabras" => array:3 [
            0 => "<span class="elsevierStyleItalic">Staphylococcus aureus</span>"
            1 => "Daptomicina"
            2 => "Endocarditis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">In a recent randomized trial of <span class="elsevierStyleItalic">Staphylococcus aureus</span> bacteremia and native valve endocarditis&#44; daptomycin was found not inferior to standard therapy&#46; We summarized findings in the subgroup of patients with endocarditis according to the Duke criteria&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Patients were randomly assigned to receive daptomycin 6<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day or standard therapy &#40;vancomycin 1<span class="elsevierStyleHsp" style=""></span>g every 12<span class="elsevierStyleHsp" style=""></span>h or antistaphylococcal penicillin 2<span class="elsevierStyleHsp" style=""></span>g every 4<span class="elsevierStyleHsp" style=""></span>h&#44; both with gentamicin 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg every 8<span class="elsevierStyleHsp" style=""></span>h for the first 4 days&#41;&#46; The primary end point was success in the modified intent-to-treat population 6 weeks after the end of therapy&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Fifty-three patients were included&#58; 35 with right-sided endocarditis &#40;RIE&#41; and 18 with left-sided endocarditis &#40;LIE&#41;&#46; The success rates in patients with RIE were similar between daptomycin and the comparator &#40;42&#37; vs 44&#37;&#41;&#46; Patients with RIE with septic pulmonary infarcts responded similarly to treatment with daptomycin and standard therapy &#40;60&#37; vs 67&#37;&#41;&#46; In the LIE population&#44; treatment success rates were poor in both arms &#40;11&#37; vs 22&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">Daptomycin is an efficacious and well-tolerated alternative to standard therapy in the treatment of RIE&#46; Patients with LIE had a poor outcome regardless of the treatment received&#46; Daptomycin is also effective in treating endocarditis with septic pulmonary infarcts&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">En un reciente ensayo aleatorizado sobre bacteriemia por <span class="elsevierStyleItalic">Staphylococcus aureus</span> y endocarditis de la v&#225;lvula natural&#44; daptomicina no result&#243; inferior a la terap&#233;utica est&#225;ndar&#46; Resumimos los hallazgos en el subgrupo de pacientes con endocarditis seg&#250;n los criterios de Duke&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Los pacientes fueron asignados aleatoriamente a recibir daptomicina&#44; 6<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#237;a&#44; o la terap&#233;utica est&#225;ndar &#40;vancomicina 1<span class="elsevierStyleHsp" style=""></span>g cada 12<span class="elsevierStyleHsp" style=""></span>h o una penicilina antiestafiloc&#243;cica 2<span class="elsevierStyleHsp" style=""></span>g cada 4<span class="elsevierStyleHsp" style=""></span>h&#44; ambos con gentamicina 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg cada 8<span class="elsevierStyleHsp" style=""></span>h&#44; durante los 4 primeros d&#237;as&#41;&#46; La variable principal fue el &#233;xito en la poblaci&#243;n modificada por intenci&#243;n de tratamiento 6 semanas despu&#233;s del final del tratamiento&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El estudio incluy&#243; a 53 pacientes&#58; 35 con endocarditis infecciosa de las cavidades derechas &#40;RIE&#41; y 18 con endocarditis infecciosa de las cavidades izquierdas &#40;LIE&#41;&#46; En los pacientes con RIE&#44; las tasas de &#233;xito con daptomicina y el tratamiento de comparaci&#243;n fueron similares &#40;42&#37; frente a 44&#37;&#41;&#46; Los pacientes con RIE e infartos pulmonares s&#233;pticos respondieron de forma similar al tratamiento con daptomicina y con la terap&#233;utica est&#225;ndar &#40;60&#37; frente a 67&#37;&#41;&#46; En la poblaci&#243;n con LIE&#44; las tasas de &#233;xito fueron pobres con ambos brazos &#40;11&#37; frente a 22&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">Daptomicina es una alternativa eficaz y bien tolerada a la terap&#233;utica est&#225;ndar en el tratamiento de la RIE&#46; Los pacientes con LIE tuvieron mal resultado&#44; con independencia del tratamiento recibido&#46; Daptomicina tambi&#233;n es eficaz en el tratamiento de la endocarditis con infartos pulmonares s&#233;pticos&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; cRIE&#44; complicated right-sided infective endocarditis&#59; IE&#44; infective endocarditis&#59; LIE&#44; left-sided infective endocarditis&#59; MITT&#44; modified intent-to-treat&#59; MRSA&#44; methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span>&#59; SIRS&#44; systemic inflammatory response syndrome&#59; uRIE&#44; uncomplicated right-sided infective endocarditis</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Characteristic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Daptomycin &#40;<span class="elsevierStyleItalic">n</span>&#61;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Comparator &#40;<span class="elsevierStyleItalic">n</span>&#61;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;yrs&#41;&#44; median &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;27&#8211;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;28&#8211;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male sex&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; median &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;18&#8211;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;19&#8211;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine clearance &#40;mL&#47;min&#41;&#44; median &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98 &#40;47&#8211;173&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;18&#8211;193&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risk factor for endocarditis&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Injection drug use&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HIV infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prior endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Preexisting valvular heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Percutaneous intravascular device&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Permanent intravascular foreign material&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Extravascular foreign material&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MRSA infection&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SIRS&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Entry diagnosis&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Definite endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Possible endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Final diagnosis&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>uRIE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>cRIE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LIE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab372912.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p class="elsevierStyleSimplePara elsevierViewall">Characteristics of patients with IE in the MITT population based on treatment assignment</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl2"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall">CI&#44; confidence interval&#59; MITT&#44; modified intent-to-treat&#59; MRSA&#44; methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus&#59;</span> MSSA&#44; methicillin-susceptible <span class="elsevierStyleItalic">Staphylococcus aureus&#59;</span> RIE&#44; right-sided infective endocarditis&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Outcome measure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Daptomycin&#44; <span class="elsevierStyleItalic">n</span>&#47;<span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Comparator&#44; <span class="elsevierStyleItalic">n</span>&#47;<span class="elsevierStyleItalic">N</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RIE</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Overall success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#47;19 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#47;16 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#91;95&#37; CI&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#91;20&#44; 66&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#91;20&#44; 70&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in MRSA subgroup&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#47;8 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;7 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in MSSA subgroup&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#47;11 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#47;9 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in patients with septic pulmonary emboli&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;10 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;9 &#40;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in patients with uncomplicated right-sided endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;6 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;4 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in patients with complicated right-sided endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;13 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;12 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Clinical success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#47;19 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#47;16 &#40;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;19 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;16 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left-sided endocarditis</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Overall success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;9 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;9 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in MRSA subgroup&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;5 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;4 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in MSSA subgroup&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;4 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;5 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Success in patients with septic pulmonary emboli&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;3 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Clinical success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;9 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#47;9 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;9 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;9 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab372913.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p class="elsevierStyleSimplePara elsevierViewall">Outcome 6 weeks after completion of study medication in patients in the MITT population</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl3"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">S&#46; aureus</span>&#44; <span class="elsevierStyleItalic">Staphylococcus aureus</span>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reason for failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Daptomycin <span class="elsevierStyleItalic">&#40;n</span>&#61;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comparator <span class="elsevierStyleItalic">&#40;n</span>&#61;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Persisting or relapsing <span class="elsevierStyleItalic">S&#46; aureus</span> infection or clinical failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinical failure without persisting or relapsing <span class="elsevierStyleItalic">S&#46; aureus</span> infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient died&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Discontinued due to adverse event&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-study antibiotics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No blood culture 6 weeks after end of therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-evaluable &#40;e&#46;g&#46;&#44; withdrew consent&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall failure rates&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab372911.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn3ast"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara">More than 1 reasons may be indicated for each patient&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p class="elsevierStyleSimplePara elsevierViewall">Reasons for treatment failure according to the adjudication committee<a class="elsevierStyleCrossRef" href="#tblfn3ast"><span class="elsevierStyleSup">&#42;</span></a></p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:28 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleItalic">Staphylococcus aureus</span> endocarditis&#58; a consequence of medical progress"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "V&#46;G&#46; Fowler Jr"
                            1 => "J&#46;M&#46; Miro"
                            2 => "B&#46; Hoen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Med Assoc"
                        "fecha" => "2005"
                        "volumen" => "293"
                        "paginaInicial" => "3012"
                        "paginaFinal" => "3021"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for nosocomial infective endocarditis in patients with methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> bacteremia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;B&#46; Hsu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/502597"
                      "Revista" => array:6 [
                        "tituloSerie" => "Infect Control Hosp Epidemiol"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "paginaInicial" => "654"
                        "paginaFinal" => "657"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16092748"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increasing rates of cardiac device infections among Medicare beneficiaries&#58; 1990&#8211;1999"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "C&#46;H&#46; Cabell"
                            1 => "P&#46;A&#46; Heidenreich"
                            2 => "V&#46;H&#46; Chu"
                            3 => "C&#46;M&#46; Moore"
                            4 => "M&#46;E&#46; Stryjewski"
                            5 => "G&#46;R&#46; Corey"
                            6 => "V&#46;G&#46; Fowler Jr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2003.06.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2004"
                        "volumen" => "147"
                        "paginaInicial" => "582"
                        "paginaFinal" => "586"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15077071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of infections associated with surgical implants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;O&#46; Darouiche"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMra035415"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "1422"
                        "paginaFinal" => "1429"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15070792"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial cardiac infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Giamarellou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/jhin.2001.1144"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hosp Infect"
                        "fecha" => "2002"
                        "volumen" => "50"
                        "paginaInicial" => "91"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11846535"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleItalic">Staphylococcus aureus</span> bacteremia and endocarditis&#46; New diagnostic and therapeutic concepts"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;A&#46; Mortara"
                            1 => "A&#46;S&#46; Bayer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Infect Dis Clin North Am"
                        "fecha" => "1993"
                        "volumen" => "7"
                        "paginaInicial" => "53"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8463653"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The changing clinical aspects of infective endocarditis&#58; descriptive review of 90 episodes in a French teaching hospital and risk factors for death"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Mouly"
                            1 => "R&#46; Ruimy"
                            2 => "O&#46; Launay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect"
                        "fecha" => "2002"
                        "volumen" => "45"
                        "paginaInicial" => "246"
                        "paginaFinal" => "256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12423613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospital-acquired infective endocarditis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Terpenning"
                            1 => "B&#46;P&#46; Buggy"
                            2 => "C&#46;A&#46; Kauffman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "1988"
                        "volumen" => "148"
                        "paginaInicial" => "1601"
                        "paginaFinal" => "1603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3382305"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of community- and health care-associated methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;S&#46; Naimi"
                            1 => "K&#46;H&#46; LeDell"
                            2 => "K&#46; Como-Sabetti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Med Assoc"
                        "fecha" => "2003"
                        "volumen" => "290"
                        "paginaInicial" => "2976"
                        "paginaFinal" => "2984"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial bloodstream infections in US hospitals&#58; analysis of 24&#44;179 cases from a prospective nationwide surveillance study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Wisplinghoff"
                            1 => "T&#46; Bischoff"
                            2 => "S&#46;M&#46; Tallent"
                            3 => "H&#46; Seifert"
                            4 => "R&#46;P&#46; Wenzel"
                            5 => "M&#46;B&#46; Edmond"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/421946"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2004"
                        "volumen" => "39"
                        "paginaInicial" => "309"
                        "paginaFinal" => "317"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15306996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical failure of vancomycin treatment of <span class="elsevierStyleItalic">Staphylococcus aureus</span> infection in a tertiary care hospital in southern Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Lutz"
                            1 => "A&#46; Machado"
                            2 => "N&#46; Kuplich"
                            3 => "A&#46;L&#46; Barth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Infect Dis"
                        "fecha" => "2003"
                        "volumen" => "7"
                        "paginaInicial" => "224"
                        "paginaFinal" => "228"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14499046"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased vancomycin MICs for <span class="elsevierStyleItalic">Staphylococcus aureus</span> clinical isolates from a university hospital during a 5-year period"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Wang"
                            1 => "J&#46;F&#46; Hindler"
                            2 => "K&#46;W&#46; Ward"
                            3 => "D&#46;A&#46; Bruckner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.01388-06"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2006"
                        "volumen" => "44"
                        "paginaInicial" => "3883"
                        "paginaFinal" => "3886"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16957043"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vancomycin treatment failures in <span class="elsevierStyleItalic">Staphylococcus aureus</span> lower respiratory tract infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;A&#46; Moise"
                            1 => "J&#46;J&#46; Schentag"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Antimicrob Agents"
                        "fecha" => "2000"
                        "volumen" => "16"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "S31"
                        "paginaFinal" => "S34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11137406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of MIC and bactericidal activity to efficacy of vancomycin for treatment of methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> bacteremia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Sakoulas"
                            1 => "P&#46;A&#46; Moise-Broder"
                            2 => "J&#46; Schentag"
                            3 => "A&#46; Forrest"
                            4 => "R&#46;C&#46; Moellering Jr"
                            5 => "G&#46;M&#46; Eliopoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.42.6.2398-2402.2004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2004"
                        "volumen" => "42"
                        "paginaInicial" => "2398"
                        "paginaFinal" => "2402"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15184410"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Activity of daptomycin against susceptible and multidrug-resistant Gram-positive pathogens collected in the SECURE study &#40;Europe&#41; during 2000&#8211;2001"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46;A&#46; Critchley"
                            1 => "D&#46;C&#46; Draghi"
                            2 => "D&#46;F&#46; Sahm"
                            3 => "C&#46; Thornsberry"
                            4 => "M&#46;E&#46; Jones"
                            5 => "J&#46;A&#46; Karlowsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2003"
                        "volumen" => "51"
                        "paginaInicial" => "639"
                        "paginaFinal" => "649"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12615866"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1699258X0572711X"
                          "estado" => "S300"
                          "issn" => "1699258X"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The safety and efficacy of daptomycin for the treatment of complicated skin and skin-structure infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;D&#46; Arbeit"
                            1 => "D&#46; Maki"
                            2 => "F&#46;P&#46; Tally"
                            3 => "E&#46; Campanaro"
                            4 => "B&#46;I&#46; Eisenstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/420818"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "1673"
                        "paginaFinal" => "1681"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15227611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Daptomycin versus standard therapy for bacteremia and endocarditis caused by <span class="elsevierStyleItalic">Staphylococcus aureus</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "V&#46;G&#46; Fowler Jr"
                            1 => "H&#46;W&#46; Boucher"
                            2 => "G&#46;R&#46; Corey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa053783"
                      "Revista" => array:7 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2006"
                        "volumen" => "355"
                        "paginaInicial" => "653"
                        "paginaFinal" => "665"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16914701"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109705007631"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Li"
                            1 => "D&#46;J&#46; Sexton"
                            2 => "N&#46; Mick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/313753"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2000"
                        "volumen" => "30"
                        "paginaInicial" => "633"
                        "paginaFinal" => "638"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10770721"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genotypic characteristics of <span class="elsevierStyleItalic">Staphylococcus aureus</span> isolates from a multinational trial of complicated skin and skin structure infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;J&#46; Campbell"
                            1 => "H&#46;S&#46; Deshmukh"
                            2 => "C&#46;L&#46; Nelson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.01822-07"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2008"
                        "volumen" => "46"
                        "paginaInicial" => "678"
                        "paginaFinal" => "684"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18077636"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleItalic">Staphylococcus aureus</span> native valve infective endocarditis&#58; report of 566 episodes from the International Collaboration on Endocarditis Merged Database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Miro"
                            1 => "I&#46; Anguera"
                            2 => "C&#46;H&#46; Cabell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/431979"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "507"
                        "paginaFinal" => "514"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16028160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhibition of daptomycin by pulmonary surfactant&#58; in vitro modeling and clinical impact"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;A&#46; Silverman"
                            1 => "L&#46;I&#46; Mortin"
                            2 => "A&#46;D&#46; Vanpraagh"
                            3 => "T&#46; Li"
                            4 => "J&#46; Alder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/430352"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Dis"
                        "fecha" => "2005"
                        "volumen" => "191"
                        "paginaInicial" => "2149"
                        "paginaFinal" => "2152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15898002"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combination antimicrobial therapy for <span class="elsevierStyleItalic">Staphylococcus aureus</span> endocarditis in patients addicted to parenteral drugs and in nonaddicts&#58; a prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "O&#46; Korzeniowski"
                            1 => "M&#46;A&#46; Sande"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1982"
                        "volumen" => "97"
                        "paginaInicial" => "496"
                        "paginaFinal" => "503"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6751182"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of cloxacillin with and without gentamicin in short-term therapy for right-sided <span class="elsevierStyleItalic">Staphylococcus aureus</span> endocarditis&#46; A randomized&#44; controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Ribera"
                            1 => "J&#46; Gomez-Jimenez"
                            2 => "E&#46; Cortes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1996"
                        "volumen" => "125"
                        "paginaInicial" => "969"
                        "paginaFinal" => "974"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8967707"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Results of surgical treatment for infective endocarditis in intravenous drug users"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Mathew"
                            1 => "G&#46; Abreo"
                            2 => "K&#46; Namburi"
                            3 => "L&#46; Narra"
                            4 => "C&#46; Franklin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1995"
                        "volumen" => "108"
                        "paginaInicial" => "73"
                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7606996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features&#44; site of involvement&#44; bacteriologic findings&#44; and outcome of infective endocarditis in intravenous drug users"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Mathew"
                            1 => "T&#46; Addai"
                            2 => "A&#46; Anand"
                            3 => "A&#46; Morrobel"
                            4 => "P&#46; Maheshwari"
                            5 => "S&#46; Freels"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "1995"
                        "volumen" => "155"
                        "paginaInicial" => "1641"
                        "paginaFinal" => "1648"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7618988"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complicated left-sided native valve endocarditis in adults&#58; risk classification for mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Hasbun"
                            1 => "H&#46;R&#46; Vikram"
                            2 => "L&#46;A&#46; Barakat"
                            3 => "J&#46; Buenconsejo"
                            4 => "V&#46;J&#46; Quagliarello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Med Assoc"
                        "fecha" => "2003"
                        "volumen" => "289"
                        "paginaInicial" => "1933"
                        "paginaFinal" => "1940"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early surgery in patients with infective endocarditis&#58; a propensity score analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46; Aksoy"
                            1 => "D&#46;J&#46; Sexton"
                            2 => "A&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/510583"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2007"
                        "volumen" => "44"
                        "paginaInicial" => "364"
                        "paginaFinal" => "372"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17205442"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The challenge of subgroup analyses&#8212;reporting without distorting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;W&#46; Lagakos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMp068070"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2006"
                        "volumen" => "354"
                        "paginaInicial" => "1667"
                        "paginaFinal" => "1669"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16625007"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:3 [
        "identificador" => "xack58661"
        "titulo" => "Acknowledgments"
        "texto" => "<p class="elsevierStylePara elsevierViewall">This work was funded by Cubist Pharmaceuticals&#46; The funding agency was involved in the study design&#44; in the collection&#44; analysis and interpretation of data&#59; in the writing of the manuscript&#59; and in the decision to submit the manuscript for publication&#46;</p> <p class="elsevierStylePara elsevierViewall">This work was approved by the individual Institutional Review Boards at the participating study sites&#46;</p>"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/0213005X/0000002800000008/v2_201308271925/S0213005X1000042X/v2_201308271925/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "8693"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/0213005X/0000002800000008/v2_201308271925/S0213005X1000042X/v2_201308271925/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X1000042X?idApp=UINPBA00004N"
]

Article information

ISSN: 0213005X
Original language: English

DOI:10.1016/j.eimc.2009.07.015

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	4	0	4
2024 October	41	14	55
2024 September	61	15	76
2024 August	56	14	70
2024 July	39	9	48
2024 June	38	18	56
2024 May	36	22	58
2024 April	42	13	55
2024 March	57	18	75
2024 February	39	15	54
2024 January	34	14	48
2023 December	48	23	71
2023 November	40	64	104
2023 October	41	37	78
2023 September	27	21	48
2023 August	13	18	31
2023 July	16	28	44
2023 June	24	18	42
2023 May	26	6	32
2023 April	27	1	28
2023 March	21	7	28
2023 February	24	10	34
2023 January	18	22	40
2022 December	17	12	29
2022 November	44	30	74
2022 October	23	15	38
2022 September	33	20	53
2022 August	27	36	63
2022 July	18	13	31
2022 June	43	10	53
2022 May	45	10	55
2022 April	47	20	67
2022 March	38	16	54
2022 February	39	8	47
2022 January	40	8	48
2021 December	60	15	75
2021 November	48	10	58
2021 October	40	12	52
2021 September	12	15	27
2021 August	26	13	39
2021 July	48	11	59
2021 June	49	9	58
2021 May	44	15	59
2021 April	57	22	79
2021 March	55	12	67
2021 February	30	11	41
2021 January	48	15	63
2020 December	51	12	63
2020 November	31	7	38
2020 October	39	8	47
2020 September	43	16	59
2020 August	35	10	45
2020 July	23	9	32
2020 June	24	8	32
2020 May	21	20	41
2020 April	16	13	29
2020 March	32	14	46
2020 February	42	18	60
2020 January	21	27	48
2019 December	43	26	69
2019 November	27	17	44
2019 October	37	22	59
2019 September	44	13	57
2019 August	33	13	46
2019 July	49	31	80
2019 June	85	31	116
2019 May	254	71	325
2019 April	91	58	149
2019 March	23	12	35
2019 February	37	15	52
2019 January	20	8	28
2018 December	28	13	41
2018 November	42	17	59
2018 October	61	21	82
2018 September	21	9	30
2018 August	8	2	10
2018 July	19	3	22
2018 June	6	2	8
2018 May	17	3	20
2018 April	15	2	17
2018 March	19	1	20
2018 February	9	0	9
2018 January	14	2	16
2017 December	18	2	20
2017 November	9	3	12
2017 October	18	3	21
2017 September	17	13	30
2017 August	24	4	28
2017 July	17	2	19
2017 June	33	24	57
2017 May	32	6	38
2017 April	35	12	47
2017 March	34	22	56
2017 February	39	4	43
2017 January	17	0	17
2016 December	24	3	27
2016 November	24	6	30
2016 October	40	4	44
2016 September	37	9	46
2016 August	29	6	35
2016 July	13	4	17
2016 June	36	5	41
2016 May	18	1	19
2016 April	30	27	57
2016 March	33	7	40
2016 February	286	22	308
2016 January	30	10	40
2015 December	27	9	36
2015 November	32	3	35
2015 October	25	7	32
2015 September	35	6	41
2015 August	19	5	24
2015 July	22	5	27
2015 June	12	2	14
2015 May	21	1	22
2015 April	21	14	35
2015 March	37	5	42
2015 February	101	22	123
2015 January	23	0	23
2014 December	36	3	39
2014 November	34	2	36
2014 October	31	6	37
2014 September	24	3	27
2014 August	22	2	24
2014 July	29	3	32
2014 June	31	2	33
2014 May	13	2	15
2014 April	21	3	24
2014 March	43	20	63
2014 February	115	50	165
2014 January	35	12	47
2013 December	56	12	68
2013 November	51	19	70
2013 October	50	19	69
2013 September	40	17	57
2013 August	60	11	71
2013 July	53	8	61
2013 June	13	3	16
2013 May	21	4	25
2013 April	18	7	25
2013 March	14	7	21
2013 February	2	3	5
2013 January	3	3	6
2012 December	3	4	7
2012 November	1	2	3
2012 October	2	2	4
2010 September	864	0	864

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter