Failure of vancomycin prophylaxis and treatment for Actinobacillus actinomycetemcomitans endocarditis

Reported is a case of Actinobacillus actinomycetemcomitans endocarditis which developed after dental prophylaxis with vancomycin and erythromycin. In vitro results indicated that this isolate and 20 additional isolates were resistant to vancomycin and that potentially useful bactericidal antibiotics for the prophylaxis and treatment of A. actinomycetemcomitans infections included gentamicin, sulfamethoxazole-trimethoprim, cefotaxime, and ciprofloxacin.