Teicoplanin in the treatment of enterococcal endocarditis: clinical and microbiological study.
Seven cases of enterococcal endocarditis treated with teicoplanin (7-10 mg/kg/day for 28-105 days) alone (one case) or in combination with aminoglycosides (six cases) were reviewed. All patients were cured. Serum bactericidal activity titres after intravenous gentamicin (5 mg/kg every 24 h) and teicoplanin (10 mg/kg every 24 h) were measured on day 7 of treatment in four patients against five enterococcal isolates: mean titres were 1:54 (range 1:16-64) and 1:22 (1:8-32) at 0.5 and 24 h post-infusion, respectively. Time-kill studies showed synergy between teicoplanin and gentamicin against three isolates. We conclude that single daily-dose teicoplanin/gentamicin combined therapy may represent a rational alternative to standard penicillin/gentamicin therapy and a useful regimen for home treatment of selected cases of enterococcal endocarditis.
Venditti
M
M
Servizio Aggregato di Consulenze Infettivologiche, Dipartimento di Medicina Clinica, Università La Sapienza, Rome, Italy.
Tarasi
A
A
Capone
A
A
Galié
M
M
Menichetti
F
F
Martino
P
P
Serra
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001770:Blood Bactericidal Activity; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D005839:Gentamicins / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D017334:Teicoplanin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D017334:Teicoplanin