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[Treatment of bacterial endocarditis with oral amoxicillin and intra-muscular gentamicin]
Abstract:
Fourteen patients suffering from bacterial endocarditis due to a streptococcus or staphylococcus were treated using a combination of amoxicillin per os in a dose of 1 gram every 2 or 3 hours and gentamicin in a dose of 60 mg intramuscularly every 6 or 8 hours. Two patients failed to tolerate amoxicillin, which had to be replaced by penicillin G. Two others, after a period of improvement, relapsed and were cured by the substitution of penicillin G given intravenously, in place of amoxicillin. The ten remaining patients were cured after a normal period of time had elapsed. Two of them were even treated at home. Bactericidal powers of serum obtained by the combination were satisfactory at between 1/16 to 1/4096 one hour after the administration of the antibiotics. This therapeutic protocol is thus effective, and has the advantage of improving the patient's comfort. It should nevertheless be reserved for use against sensitive organisms in patients without digestive problems, the bactericidal power of the serum being verified.
Insights
This study found that combining amoxicillin and gentamicin effectively treated bacterial endocarditis in most patients. This antibiotic regimen offers improved patient comfort and can be administered at home for sensitive bacterial infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Cardiology
Context:
- Bacterial endocarditis is a serious infection requiring effective antibiotic treatment.
- Streptococcus and Staphylococcus are common causative agents of endocarditis.
- Optimizing antibiotic regimens is crucial for patient outcomes and comfort.
Purpose:
- To evaluate the efficacy and tolerability of a combined amoxicillin and gentamicin regimen for bacterial endocarditis.
- To assess the bactericidal activity of serum post-treatment.
- To explore the potential for outpatient management with this regimen.
Summary:
- Fourteen patients with streptococcal or staphylococcal endocarditis received amoxicillin (1g q2-3h) and gentamicin (60mg q6-8h).
- Ten patients were cured with this regimen; two required penicillin G due to intolerance, and two others relapsed and were treated with intravenous penicillin G.
- Satisfactory serum bactericidal activity (1/16 to 1/4096) was observed, with two patients successfully treated at home.
Impact:
- The amoxicillin-gentamicin combination demonstrates effectiveness in treating bacterial endocarditis, offering improved patient comfort.
- This regimen may allow for home-based treatment in select cases with sensitive organisms and no digestive issues.
- Monitoring serum bactericidal power is recommended to ensure therapeutic efficacy.