Medical treatment of staphylococcal infective endocarditis

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Ressource 1Download: serval:BIB_B2C39F86CA5A.P001 (335.73 [Ko])
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Serval ID
serval:BIB_B2C39F86CA5A
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Medical treatment of staphylococcal infective endocarditis
Journal
European Heart Journal
Author(s)
Bille  J.
ISSN
0195-668X
Publication state
Published
Issued date
04/1995
Peer-reviewed
Oui
Volume
16 Suppl B
Pages
80-3
Language
english
Notes
Journal Article
Review --- Old month value: Apr
Abstract
Staphylococcal infective endocarditis is a severe event requiring aggressive therapy. Antibiotic regimen depends mainly on (1) the species of Staphylococcus (Staphylococcus aureus versus coagulase-negative staphylococci) and its resistance pattern (resistance to penicillin, to methicillin, to multiple classes of antibiotics); (2) the type of infected valve (native versus prosthetic); (3) the site of infection (left side versus right side endocarditis); (4) some underlying conditions of the host, in particular the presence or not of intravenous drug abuse. Based on in vitro susceptibility results, animal models and clinical trials, the following regimens are currently recommended. For native valve endocarditis, penicillin G 20 million units per day i.v. for 4-6 weeks for penicillin-susceptible strains; a penicillinase-resistant penicillin (oxacillin) 2 g i.v. q 4 h for 4-6 weeks plus an aminoglycoside (gentamicin) 1.0 mg.kg-1 i.v. q 8 h for 1 week, for penicillin-resistant, methicillin-susceptible strains; for methicillin resistant strains, vancomycin 30 mg.kg.day-1 i.v. in 2-4 doses for 4-6 weeks with the addition or not of rifampin 600-900 mg.day-1 orally. For a prosthetic valve endocarditis, a three-drug regimen (oxacillin or vancomycin, plus gentamicin and rifampin) and a longer duration (6 weeks or more) are generally recommended. Shorter (2 weeks) treatment could be delivered to uncomplicated cases of right-sided endocarditis. In view of an increased resistance to classic drugs and suboptimal efficacy of some of them, new therapeutic modalities should be looked at, in particular for endocarditis cases due to methicillin-resistant strains.
Keywords
Anti-Bacterial Agents/*administration & dosage Drug Administration Routes Drug Therapy, Combination/administration & dosage Endocarditis, Bacterial/*drug therapy/microbiology Humans Staphylococcal Infections/*drug therapy/microbiology
Pubmed
Web of science
Open Access
Yes
Create date
11/02/2008 13:40
Last modification date
01/10/2019 7:19
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