Enterococcal infections endocarditis

Penicillin plus streptomycin is effective for enterococcal endocarditis and 2-week therapy of viridans streptococcal endocarditis. Gentamicin has largely replaced streptomycin for these indications. Streptomycin remains a useful agent for treating enterococcal infections, however, because approximately 15% of enterococcal isolates that are resistant to gentamicin (and therefore to netilmicin, tobramycin, and amikacin) will be susceptible to streptomycin. 

EUopoUs GM. Enterococcal endocarditis. In Kaye D, ed. Infective Endocarditis, 2d ed. New York, Raven Press, 1992 209—223. 

Bacterial endocarditis. An aminoglycoside, usually gentamicin, should comprise part of the antimicrobial combination for enterococcal, streptococcal or staphylococcal infection of the heart valves, and for the therapy of clinical endocarditis which fails to yield a positive blood culture. 

Antimicrobial combination therapy is used frequently to treat serious infections. Combination therapy may be used prior to knowing the pathogen or antibiotic susceptibility for the treatment of infections in neutropenic patients and in patients with enterococcal endocarditis or bacteremia, sepsis, or pneumonia caused by P. aeruginosa. In these cases, it is important to know whether the combination will have beneficial (or detrimental) effects on the overall antibacterial activity of the regimen. For example, the combination may result in activity that is... 

EUopoUs GM. Aminoglycoside resistant enterococcal endocarditis. Infect Dis CUn North Am 1993 7 117-133. 

In penicillin-allergic patients, vancomycin is an effective alternative for the treatment of endocarditis caused by viridans streptococci or, combined with an aminoglycoside, for enterococcal endocarditis. Vancomycin has become an important antibiotic in the management of known or suspected penicillin-resistant pneumococcal infections. 

A patient needs antibiotic treatment for native valve, culture-positive infective enterococcal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with (A) Amoxicillin/clavulanate Aztreonam... 

Natural penicillin Infections like streptococcal pneumonia, enterococcal and nonenterococcal group D endocarditis, diphtheria, anthrax, meningitis, tetanus, botulism, actinomycosis, syphilis, and relapsing fever, Lyme disease prophylaxis against pneumococcal infections, rheumatic fever, bacterial endocarditis... 

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