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[Enterococcal endocarditis: clinical features and therapeutic approach]

A Perrone1, G Guida, C M Morano

  • 1Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Università, Bari.

Recenti Progressi in Medicina
|January 31, 1998
PubMed
Summary

Enterococci cause infective endocarditis, especially in older adults with GI/GU issues. A combination of teicoplanin and ampicillin/sulbactam proved effective in treating these serious infections.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pharmacology

Background:

  • Enterococci are a significant cause of infective endocarditis (IE), particularly in elderly patients with gastrointestinal or genitourinary conditions.
  • Enterococcal IE is associated with high morbidity and mortality due to treatment challenges.
  • Glycopeptide antibiotics are increasingly recognized for their efficacy against enterococci.

Purpose of the Study:

  • To assess the efficacy of teicoplanin combined with ampicillin plus sulbactam for treating enterococcus-mediated endocarditis.
  • To evaluate clinical recovery and bacteriologic eradication rates in a cohort of patients with enterococcal endocarditis.

Main Methods:

  • A study of 27 consecutive patients with enterococcus-mediated endocarditis treated between June 1987 and September 1995.

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  • The treatment regimen included teicoplanin in association with ampicillin plus sulbactam.
  • Identified the source of infection in 17 patients, with the gastrointestinal tract being the most common origin.

    • Main Results:

    • Successful clinical recovery and bacteriologic eradication were achieved in 24 out of 27 patients (88.8%).
    • The gastrointestinal tract was identified as the source of infection in the majority of cases (17 patients).

    Conclusions:

    • The combination of teicoplanin and ampicillin plus sulbactam demonstrates high efficacy in treating enterococcus-mediated endocarditis.
    • Prophylactic antibiotic treatment is recommended for elderly individuals with gastrointestinal diseases.
    • Further research into optimal therapeutic strategies for enterococcal IE is warranted.