Antimicrobial treatment of infective endocarditis caused by viridans streptococci highly susceptible to penicillin: historic overview and future considerations

J Antimicrob Chemother. 2006 May;57(5):819-24. doi: 10.1093/jac/dkl087. Epub 2006 Mar 20.

Abstract

In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to penicillin. Early treatment trials indicate that some patients with subacute endocarditis can be cured with shorter treatment duration than currently advised by international guidelines. Also, high-dose antibiotics, as recommended today, have a predominantly pharmacokinetic and pharmacodynamic rationale that is based mostly on experimental animal studies. Shortening antimicrobial treatment in select patients with endocarditis would be of great benefit. As yet there are no predictors of cure that can be used to individualize treatment duration in patients with bacterial endocarditis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Endocarditis, Subacute Bacterial / drug therapy*
  • Endocarditis, Subacute Bacterial / microbiology
  • Humans
  • Penicillins / administration & dosage
  • Penicillins / therapeutic use*
  • Streptococcal Infections / drug therapy*
  • Streptococcal Infections / microbiology
  • Treatment Outcome
  • Viridans Streptococci / drug effects*
  • Viridans Streptococci / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Penicillins