POIATEic Insight: Oral versus Intravenous Treatment for Infective Endocarditis & Bariatric Surgery in Diabetes


Andre Maddison, General Internal Medicine (GIM) fellow at Western University, is hosting this week’s episode on The Rounds Table alongside Erin Spicer, faculty member in GIM also at Western University.  This week they cover partial oral versus intravenous antibiotic treatment of infective endocarditis (POIATE trial) and microvascular outcomes in patients with type 2 diabetes mellitus (T2DM) after bariatric surgery.

Patients with left-sided infective endocarditis are usually treated with intravenous antibiotics for up to six weeks. Keeping patients in hospital or discharging them with an intravenous line can pose challenges to the patient and the healthcare system. Erin takes listeners through the POIATE trial to determine if switching from intravenous to, more conveniently, oral antibiotics is safe in patients with left-sided endocarditis.

Bariatric surgery has been increasingly gaining momentum as a method for weight loss and to manage the comorbidities associated with obesity.  Some studies have reported improvement in HbA1c and remission of diabetes post-bariatric surgery.  Andre walks listeners through a study of patients with obesity and T2DM in the United States, comparing the development of microvascular complications with bariatric surgery versus usual care.

Finally, the Good Stuff segment.  Erin covers an article on drug-checking centres for illicit substances as a harm reduction strategy.  Andre reviews an interview with an Otolaryngology surgeon in Newfoundland on why medical schools are recruiting students with undergraduate degrees in music.

Like what you hear?  Rate us on iTunes!  Chat with us on Twitter at @roundstable and tweet at Western University’s Medicine and Dentistry program @SchulichMedDent.

Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, email wkwong@qmed.ca.

The Papers

1. POIATE: https://www.nejm.org/doi/10.1056/NEJMoa1808312?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov

2. Bariatric Surgery in T2DM: http://annals.org/aim/article-abstract/2696493/microvascular-outcomes-patients-diabetes-after-bariatric-surgery-versus-usual-care?doi=10.7326%2fM17-2383

Good Stuff

1. Drug-Checking Centres: https://www.theglobeandmail.com/canada/article-in-amsterdam-drug-checking-centres-make-sure-illegal-substances-are/

2. From Musician to Physician: https://www.cbc.ca/news/canada/newfoundland-labrador/medicine-music-connection-1.4770372

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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