title: Ceftriaxone plus gentamicin or ceftriaxone alone for streptococcal endocarditis in Japanese patients as alternative first-line therapies.
abstract: This study included 31 patients who had definite or possible infectious endocarditis as defined by the modified Duke's criteria Of these patients, 27 were treated with ceftriaxone plus gentamycin combination therapy and four with ceftriaxone monotherapy. Of these 31 cases, 29 had infections with Streptococcus species, and showed good responses to penicillin G and cefotaxime. Excluding one patient who died because of the underlying disease, all patients achieved clinical cure after treatment with either of the two regimens, showing no recurrence during a follow-up period of 6 months after completion of drug treatment. Although valve replacement was performed in 10 patients during the follow-up period, there were no recurrences in any of these patients 6 months postoperatively. Ceftriaxone allows a simple regimen of once-daily administration. Although indications are limited, ceftriaxone therapy is feasible on an outpatient basis, offering favorable medical economics. Consistent with previous reports, the therapeutic effect of ceftriaxone was equivalent to that of penicillin G in this study, showing this agent to be an alternative first-line drug for infectious endocarditis.
authors.affiliation: Department of Infectious Disease, Tokyo Women's Medical University, Tokyo, Japan. yuji-hirai@clabo.twmu.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirai
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ainoda
authors.forename: Takayo
authors.initials: T
authors.lastname: Shoji
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Totsuka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005839:Gentamicins / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013291:Streptococcus / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002443:Ceftriaxone