Introduction:

Infective endocarditis is a disease of low incidence but high morbidity. It can have an acute or subacute course, with complications that are directly related to mortality and vary according to the infectious agent; the most common is Staphylococcus aureus. Based on the clinical condition, an exclusive antimicrobial therapy or a combined therapy (antimicrobial and surgery) can be chosen; their proper choice impacts survival rates.

Objective:

To describe the clinical, microbiological and echocardiographic characteristics in patients with infective endocarditis and to analyze how mortality behaved according to the treatment received (antimicrobial therapy or combined therapy).

Method:

A retrospective cohort study, carried out at the Fundación Valle del Lili University Hospital, Cali, Colombia, which included hospitalized patients over 18 years of age who met modified Duke criteria for the diagnosis of infective endocarditis. Two cohorts were evaluated according to treatment: exclusive antimicrobial and combined therapy. They were followed until discharge from the hospital.

Results:

Of 101 patients, 58 received antimicrobial therapy and 43 combined therapy. Overall survival was 77.35%, the combined therapy group had an adjusted hazard ratio of 0.13 (95% confidence interval: 0.036-0.505; p = 0.003). The mortality rate calculated per 1000 person-days was 25.9 in antimicrobial therapy and 4.33 in combination therapy.

Conclusions:

the combined therapy group had more complications and a longer hospital stay in the ICU, but lower mortality rates than the patients on exclusive antimicrobial therapy. According to the current indications for surgical management described in international guidelines, excellent results can be obtained in sicker patients.

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