Short-term therapy for streptococcal infective endocarditis. Combined intramuscular administration of penicillin and streptomycin.
In a prospective study, 91 patients with penicillin-sensitive infective endocarditis (IE) were treated for two weeks with intramuscular (IM) penicillin G procaine, 1.2 million units every six hours, plus streptomycin sulfate, 500 mg IM every 12 hours. Viridans streptococci were isolated from 70 patients (77%); 21 patients (23%) had Streptococcus bovis infections. Eighteen patients (20%) had had symptoms of IE for three months or longer. Follow-up ranged from two months to 6.6 years. There were no relapses; mild vestibular toxic reactions occurred in two patients (2%). Two patients (2%) died--one of sudden-onset severe heart failure and one of cardiac arrest after aortic valve replacement. Twenty-six patients (19%) required cardiac valve replacement after completion of antimicrobial therapy. This therapy seems as efficacious as four weeks of parenteral antimicrobial therapy and is more cost-effective.
D000293:Adolescent; D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D010402:Penicillin G Procaine / Q000008:administration & dosage*; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy*; D013307:Streptomycin / Q000008:administration & dosage*; D013997:Time Factors
D010402:Penicillin G Procaine; D013307:Streptomycin