ANTIBIOTIC-TREATMENT OF STREPTOCOCCAL AND ENTEROCOCCAL ENDOCARDITIS -AN OVERVIEW

The management of streptococcal and enterococcal endocarditis has chan ged in recent years with the development of effective new regimens tha t are easier to administer, but resistance to commonly used antibiotic s has appeared, especially among enterococci. Beta-lactam antibiotics either alone or in combination are suitable for most patients with vir idans streptococci. Streptococci bovis, and S. pneumoniae, but alterna tive regimens are necessary for special situations. Group B, C and G s treptococci respond best to the combination of a penicillin and an ami noglycoside. Enterococci are relatively resistant to penicillins and c ephalosporins and strains resistant to beta-lactams, glycopeptides and aminoglycosides have become more common lately. Strategies are propos ed dependent on the resistance of the organisms, but it is recognized that medical failure is not uncommon and surgical removal of the infec ted valve may be the only curative treatment.