Short-course therapy for right-side endocarditis due to Staphylococcus aureus in drug abusers: cloxacillin versus glycopeptides in combination with gentamicin.
A prospective, randomized clinical trial among drug abusers was conducted to assess the efficacy and safety of a short course of a combination of a glycopeptide (vancomycin or teicoplanin) and gentamicin compared with a combination of cloxacillin and gentamicin for treatment of right-side endocarditis caused by Staphylococcus aureus. Therapeutic success was significantly more frequent with cloxacillin than with a glycopeptide. No adverse effects were noted among patients in the cloxacillin group. A 14-day course of vancomycin or teicoplanin plus gentamicin is ineffective in this instance because it is associated with a high rate of clinical and microbiological failure.
Fortún
J
J
Infectious Diseases Department, Hospital Ramón y Cajal, Madrid, Spain. fortun@mi.madritel.es
Navas
E
E
Martínez-Beltrán
J
J
Pérez-Molina
J
J
Martín-Dávila
P
P
Guerrero
A
A
Moreno
S
S
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003023:Cloxacillin / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004697:Endocarditis, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006020:Glycopeptides; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D006020:Glycopeptides; D003023:Cloxacillin