[Enterococcal endocarditis: clinical features and therapeutic approach]

Enterococci are implicated in about 20% of cases of infective endocarditis, topically in aged subjects with gastro-intestinal and/or genitourinary diseases. These forms are usually associated with an increased morbidity and mortality, in that also reflecting the difficulties encountered to set up a specific therapeutic approach. Among the various antibiotics effective against enterococci, particular attention has been recently given to those belonging to glycopeptide group. In the current study we have assessed the efficacy of teicoplanin associated to ampicillin plus sulbactam in 27 consecutive patients with enterococcus-mediated endocarditis, admitted to our hospital between June 1987 and September 1995. In 17 patients the source of infection has been identified in the gastrointestinal tract. The clinical recovery and the bacteriologic eradication have been achieved in 24/27 (88.8%) patients. The results indicate the necessity of a prophylactic antibiotic treatment in aged individuals with diseases affecting the gastrointestinal tract and further suggest the efficacy of teicoplanin and ampicillin plus sulbactam association for the treatment of endocarditis caused by enterococci.