Infective endocarditis caused by Enterococcus faecalis treated with continuous infusion of ampicillin without adjunctive aminoglycosides

Intern Med. 2013;52(10):1131-5. doi: 10.2169/internalmedicine.52.8425. Epub 2013 May 15.

Abstract

Aminoglycosides are useful antimicrobial agents for treating infective endocarditis; however, they occasionally cause troublesome side effects, such as nephrotoxicity and ototoxicity. We herein report a case of infective endocarditis caused by Enterococcus faecalis that was treated successfully with continuous infusion of ampicillin without adjunctive aminoglycosides. The serum ampicillin concentrations were higher than the minimal inhibitory concentration for the target strain. Although the use of ampicillin monotherapy is currently avoided because double β-lactam therapy is reportedly more effective, continuous penicillin administration remains an effective therapeutic choice for treating infective endocarditis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aminoglycosides / adverse effects
  • Ampicillin / administration & dosage
  • Ampicillin / blood
  • Ampicillin / pharmacology
  • Ampicillin / therapeutic use*
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / blood
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Anticoagulants / therapeutic use
  • Arthroplasty, Replacement, Hip
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy
  • Contraindications
  • Diagnosis, Differential
  • Endocarditis, Bacterial / blood
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / microbiology
  • Enterococcus faecalis / drug effects
  • Enterococcus faecalis / isolation & purification*
  • Femoral Neck Fractures / surgery
  • Gram-Positive Bacterial Infections / blood
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Infusions, Intravenous
  • Male
  • Microbial Sensitivity Tests
  • Mitral Valve / microbiology
  • Postoperative Complications / drug therapy
  • Postoperative Complications / microbiology
  • Practice Guidelines as Topic
  • Pyelonephritis / diagnosis
  • Streptomycin
  • Warfarin / therapeutic use

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Anticoagulants
  • Warfarin
  • Ampicillin
  • Streptomycin