Gentamicin streptococcal

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. 

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. 

Gavalda J, Pahissa A, Almirante B, et al. Effect of gentamicin dosing interval on therapy of viridans streptococcal experimental endocarditis with gentamicin plus penicillin. Antimicrob Agents Chemother 1995 39 2098-2103. 

Sexton DJ, Tenenbaum Ml, Wilson WR, et al. Ceftriaxone once daily for 4 weeks compared to ceftriaxone plus gentamicin once daily for 2 weeks for treatment of penicillin-susceptible streptococcal endocarditis. Clin Infect Dis 1998 27 1470-1474. 

Bacterial Endocarditis Streptomycin and penicMn in combination are synergisticaUy bactericidal in vitro against strains of enterococci, group D streptococci, and the various oral streptococci of the viridans group. A combination of penicUhn G and streptomycin may be indicated for treatment of streptococcal or enterococcal endocarditis. Streptomycin largely has been replaced by gentamicin but may still be used when the strain is resistant to gentamicin and susceptible to streptomycin. 

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