The role of glycopeptide antibiotics in the treatment of infective endocarditis

There are several sets of guidelines for the treatment of infective endocar ditis, reflecting the need for differing treatment in various countries and times. This review considers the need for differing treatment modalities a nd in particular the utility of the glycopeptide antibiotics vancomycin and teicoplanin. Specific recommendations are offered as to when to consider t he use of glycopeptides, appropriate dosage, length of treatment course and whether to use monotherapy or combined therapy. Used judiciously, the glyc opeptides give results as good as can be achieved with other antimicrobial agents without exceptional toxicity. The potential of teicoplanin for use i n the outpatient treatment of infective endocarditis is considered. (C) 199 9 Elsevier Science B.V. and International Society of Chemotherapy. All righ ts reserved.