ANTIBIOTIC-TREATMENT OF ADULTS WITH INFECTIVE ENDOCARDITIS DUE TO STREPTOCOCCI, ENTEROCOCCI, STAPHYLOCOCCI, AND HACEK MICROORGANISMS

Objective.-To provide guidelines for the treatment of endocarditis in adults caused by the following microorganisms: viridans streptococci a nd other streptococci, enterococci, staphylococci, and fastidious gram -negative bacilli of the HACEK group. Participants.-An ad hoc writing group appointed by the American Heart Association under the auspices o f the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease , Council on Cardiovascular Disease in the Young. Evidence.-Published studies of the treatment of patients with endocarditis and the collect ive clinical experience of this group of experts. Consensus Process.-T he recommendations were formulated during meetings of the working grou p and were prepared by a writing committee after the group had agreed on the specific therapeutic regimens. The consensus statement was subs equently reviewed by standing committees of the American Heart Associa tion and by a group of experts not affiliated with the working group. Conclusions.-Sufficient evidence has been published that recommendatio ns regarding treatment of the most common microbiological causes of en docarditis (viridans streptococci, enterococci, Streptococcus bovis, s taphylococci, and the HACEK organisms) are justified. There are insuff icient published data to make a strong statement regarding the efficac y of specific therapeutic regimens for cases of endocarditis due to mi croorganisms that uncommonly cause endocarditis. As a useful aid to th e practicing clinician, the writing group developed a consensus opinio n regarding management of endocarditis caused by the most commonly enc ountered microorganisms and regarding those cases due to infrequent ca uses of endocarditis.