Efficacy of the combination ampicillin plus ceftriaxone in the treatment of a case of enterococcal endocarditis due to Enterococcus faecalis highly resistant to gentamicin: efficacy of the "ex vivo" synergism method.
The case of a patient with highly gentamicin-resistant Enterococcus faecalis endocarditis treated with an ampicillin + ceftriaxone combination is described. We have designed a method to evaluate synergism between the antibacterial activity of patient's serum taken during a given antibiotic regimen (ampicillin) to which another antibiotic (ceftriaxone) is added in vitro. In this patient the two-drug combination was able to stop the bacteremia and prevent the infection of the prosthetic valve.
Tascini
C
C
Division of Infectious Diseases, Pisa Hospital, Pisa, Italy. c.tascini@ao-pisa.toscana.it
Doria
R
R
Leonildi
A
A
Martinelli
C
C
Menichetti
F
F
D000368:Aged; D000667:Ampicillin / Q000008:administration & dosage*; D002443:Ceftriaxone / Q000008:administration & dosage*; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000302:isolation & purification; D005500:Follow-Up Studies; D005839:Gentamicins / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D018570:Risk Assessment; D016896:Treatment Outcome
D005839:Gentamicins; D002443:Ceftriaxone; D000667:Ampicillin