Current treatment options of infective endocarditis

Journal of Clinical and Basic Cardiology 2001; 4 (1): 25-30

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Keywords: Behandlung,  Endokarditis,  Herz,  Infektion,  endocarditis,  heart,  infection,  treatment

Grampositive cocci (Streptococcus viridans and bovis, Enterococci, Staphylococcus aureus, coagulase-negative staphylococci) and the so-called HACEK-micro-organisms are the most common causative agents of infectious endocarditis (IE). Although gramnegative Enterobacteriaceae often cause bacteraemia, they rarely cause IE. About 30 % of IE are based on intravenous drug abuse or invasive medical procedures. Treatment strategies for streptococcal endocarditis differentiate between sensitive streptococci (MIC < 0.1 µg/ml), intermediate penicillin-resistant streptococci (MIC between 0.1 and 0.5 µg/ml), and penicillin-resistant streptococci (MIC > 0.5 µg/ml) or enterococci. Treatment strategies for staphylococcal endocarditis distinguish between Staphylococcus aureus and coagulase-negative staphylococci on the one hand and infection of native and prosthetic valves on the other hand. Members of the HACEK group make up about 5 % of native valve IE in non-drug addicts and are treated with ampicillin (plus/minus gentamicin) for beta-lactamase negative strains and with third generation cephalosporins in case of known or unknown beta-lactamase production. J Clin Basic Cardiol 2001; 4: 25-30.