[Proceedings: Chemotherapy of bacterial endocarditis]

The present concepts of antibiotic therapy in bacterial endocarditis are reviewed. Recommendations for the treatment of the most frequent pathogens -- streptococci of the viridans group, enterococci, staphylococci -- and for unknown organisms are presented. Antimicrobial therapy directed against gramnegative organisms, especially of the pseudomonas group, and against anaerobic bacteria is briefly discussed. The presence of renal impairment calls for adjustment of dosage; relevant nomograms are published in the literature. Probenecid may be added to the antibiotic therapy to increase serum levels of penicillins and some cephalosporins, though a major drawback is its side effects. Clinical experience teaches that every recrudescence of bacterial endocarditis adds permanent damage to an already impaired valve. Hence it is of utmost importance that the aim of antimicrobial therapy should be a 100% cure.