Role of aminoglycosides in the treatment of bacterial endocarditis.
Aminoglycosides are often used in combination with glycopeptides and beta-lactams for the treatment of bacterial endocarditis caused by alpha-haemolytic streptococci, staphylococci and enterococci. Recommendations on dosing and duration of aminoglycoside therapy vary; we detail the laboratory and clinical evidence base for the treatment regimens advised. A number of deficiencies in the published guidelines are highlighted, as is the limited evidence base upon which many of the regimens are recommended. With the increasing use of outpatient treatment of severe infections and once daily administration of aminoglycosides the opportunity should be taken for larger, multicentre clinical trials to evaluate formally both old and new regimens.
Graham
J C
JC
Microbiology Department, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK. j.c.graham@ncl.ac.uk
Gould
F K
FK
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D016983:Enterococcus / Q000187:drug effects*; D006350:Heart Valve Prosthesis; D006801:Humans; D017410:Practice Guidelines as Topic; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013210:Staphylococcus / Q000187:drug effects*; D013290:Streptococcal Infections / Q000188:drug therapy*; D016985:Streptococcus bovis / Q000187:drug effects*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents