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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-one strains of Streptococcus mutans (34 from blood specimens from patients with endocarditis and 7 from stock cultures) were tested for susceptibility to penicillin, ampicillin, methicillin, erythromycin, cephalothin, vancomycin, chloramphenicol, tetracycline, gentamicin, streptomycin, and kanamycin. Minimal inhibitory and bactericidal concentrations were determined by a broth microdilution procedure. Most of the strains were very susceptible to ampicillin, penicillin, and erythromycin, with most strains having minimal inhibitory concentrations of 0.08 mug/ml or less. Most of the strains were also susceptible to cephalothin, methicillin, chloramphenicol, tetracycline, and vancomycin. Gentamicin was the most effective aminoglycoside. The antimicrobial susceptibility patterns are similar to those of other viridans streptococci. S. mutans strains have proven to be difficult for some microbiologists to identify. But when organisms suggesting S. mutans are isolated from patients with endocarditis, they should be at least identified as nonenterococcal streptococci so that appropriate therapy can be initiated.
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PMID:Antimicrobial susceptibility of Streptococcus mutans isolated from patients with endocarditis. 484 Apr 35

The bactericidal activity of benzylpenicillin and ampicillin on 21 strains of enterococci was evaluated and compared to the activity of these drugs in combination with streptomycin (20 mug/ml). On a weight basis, ampicillin was about twice as effective as benzylpenicillin. Neither of the drugs was rapidly and completely bactericidal for any of the 21 strains of enterococci when used alone. The addition of streptomycin greatly enhanced the early bactericidal rate achieved with any given amount of either penicillin and permitted the elimination of viable organisms in vitro. These results suggest that, for the time being, combined antibiotic therapy might be desirable in enterococcus endocarditis and that ampicillin, although more effective than benzylpenicillin, should not be relied upon as a single drug in that disease.
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PMID:Comparison of the action of ampicillin and benzylpenicillin on enterococci in vitro. 564 24

Aminoglycosides still play a major role int e treatment of severe infections, especially those due to Gram-negative bacilli. They are usually administered together with a beta-lactam antibiotic, either to cover a wide antibacterial spectrum, or to obtain a better bactericidal effect, or to prevent the emergence of resistant mutants. They are mainly used in severe urinary tract infections and/or in those due to multiresistant organisms and in Gram-negative pneumonia and meningitis (intrathecally, since they poorly diffuse into the CSF). Combined with cephalosporins they constitute the first-line treatment of severe, life-threatening infections caused by Gram-negative aerobes. Given simultaneously with penicillinase-resistant semi-synthetic penicillins or with vancomycin they act synergistically against staphylococci and can be used initially for a few days in the treatment of severe staphylococcal infections. It is also for this synergistic action that they are combined with penicillin G or ampicillin in the treatment of endocarditis. The ototoxic or nephrotoxic effects common to all aminoglycosides can be avoided by adjusting the doses to the degree of renal function, by limiting their use to about a fortnight (except for endocarditis) and by monitoring blood levels.
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PMID:[Current therapeutic indications of aminoglycosides]. 623 28

The authors report one observation of endocarditis due to Hemophilus para-influenzae associated with mitral valve prolapsus. This germ is difficult to isolate and is found late in cultures using standard techniques. The dicovery of germs resistant to ampicillin requires the search for the presence of a betalactamase. When resistant germs are found, the antibiotic of choice is chloramphenicol or cefamandole. This type of endocarditis different from the others on account of the risk major of embolism (60-85 p. 100) which justifies valve replacement when the echography reveals persistant vegetations.
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PMID:[Endocarditis due to Hemophilus para-influenzae associated with mitral valve prolapses (author's transl)]. 625 33

The efficacy of combined therapy with ampicillin and a beta-lactamase inhibitor, CP-45,899, for experimental endocarditis due to Staphylococcus aureus was evaluated. Three strains of beta-lactamase-producing S. aureus were used, and intramuscular doses of antibiotics were selected to produce serum levels in rabbits similar to those expected in humans. Sera from animals treated with ampicillin plus CP-45,899, but not from those treated with nafcillin plus gentamicin, had bactericidal activity against two nafcillin-resistant strains of S. aureus at 1 hr. The combination of ampicillin plus CP-45,899 was as effective as nafcillin in treatment of endocarditis due to one nafcillin-sensitive strain and was superior to nafcillin against two nafcillin-resistant strains (P less than 0.001). In a short-term treatment experiment using the nafcillin-sensitive strain, ampicillin plus CP-45,899 sterilized vegetations as rapidly as nafcillin plus gentamicin. Thus, ampicillin plus a beta-lactamase inhibitor may be effective treatment for bacteremic infections due to S. aureus, even when the strain is nafcillin-resistant.
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PMID:Efficacy of ampicillin plus a beta-lactamase inhibitor (CP-45,899) in experimental endocarditis due to Staphylococcus aureus. 626 15

A new case of septicemia (without endocarditis) due to Actinobacillus actinomycetum comitans is described. The patient was a 59-year-old man with an intraventricular pacemaker. He was successfully treated by a combination of gentamicin and ampicillin. Human infections due to this demanding and slow-growing micro-organism, which is not related to actinomycosis, are only exceptionally reported. In 73% of the cases the endocarditis is subacute. The study of the literature demonstrates the prevalence of male patients and the usual absence of leukocytosis.
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PMID:[Septicemia due to an unusual micro-organism: Actinobacillus actinomycetum comitans (author's transl)]. 627 10

Seventy-six strains of various species of streptococci isolated from patients with infective endocarditis were tested for their susceptibility to 13 antibiotics by an agar dilution method. The antibiotics tested were: benzyl-penicillin, ampicillin, cefotaxime, vancomycin, erythromycin, rifampicin, pristinamycin, gentamicin, netilmicin, tobramycin, amikacin, dibekacin and streptomycin. Excluding enterococci, 91% of strains were sensitive to benzylpenicillin. Resistance to benzylpenicillin was only found in some strains of S. sanguis I, S. sanguis II and S. mitis. Enterococci were more sensitive to ampicillin. Cefotaxime was highly active against all strains, except enterococci. Vancomycin was active against all strains. Resistance to erythromycin was found in 16% of isolates. Rifampicin and pristinamycin were highly active against all strains, except some enterococci. Gentamicin and netilmicin were the most active of the six aminoglycosides tested. High level resistance to streptomycin was seen in six strains. Overall, S. agalactiae was more resistant to the aminoglycosides than the other species. Among the non-groupable streptococci, strains of S. mitis, S. sanguis I and S. sanguis II were the least sensitive to many antibiotics. Benzylpenicillin remains the antibiotic of choice for the treatment of IE caused by streptococci. If the MIC exceeds 0.1 mg l-1, an aminoglycoside (netilmicin or gentamicin) should be added and the duration of treatment increased from 4 to 6 weeks.
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PMID:Antibiotic susceptibility of streptococcal strains associated with infective endocarditis. 639 32

Severe infectious diseases treatment often needs a frequent antimicrobial agent blood levels control. These controls are still performed by microbiological assay procedure. High performance liquid chromatography (HPLC) is now allowing a new kind of assay procedure and improves on speed, specificity and sensitivity. We developed a procedure allowing us to monitor every day by routine, five beta-lactam antibiotics with only one analytical column: benzylpenicillin, ampicillin, cloxacillin, mezlocillin and cefotaxime. A single extraction procedure suitable to the five beta-lactam antibiotics and to various body fluids and the use of three mobile phases, permit us to give a quick answer to the clinicians and thus to consider a rapid adaptation of the doses being administered. In consideration of the specificity, it is possible to control blood levels of each beta-lactam antibiotic even by associated antimicrobial treatment, what is sometimes impossible using the microbiological assay procedure. Cefotaxime is well separated from its active metabolite desacetyl-cefotaxime. The disparity of the levels obtained, for the same posology, essentially by prematures and new-borns, but also in case of massive infusions for endocarditis justify the use of a rapid and specific procedure like high performance liquid chromatography (HPLC).
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PMID:[Focus and value of the assay of 5 beta-lactams using high-performance liquid chromatography]. 641 37

This report describes the capacities of ampicillin, vancomycin, streptomycin, gentamicin, and combinations thereof to prevent endocarditis in rabbits challenged with either streptomycin-resistant (three strains) or streptomycin-susceptible (one strain) Streptococcus faecalis. Vancomycin (15 mg/kg) alone was effective in preventing infection with three of four strains, including two which were streptomycin resistant. Vancomycin (30 mg/kg) alone was effective against the other streptomycin-resistant strain. The vancomycin-gentamicin combination was the only therapeutic regimen to demonstrate complete prophylaxis for all strains regardless of streptomycin susceptibility. The ampicillin-gentamicin combination was variably effective despite in vitro synergism.
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PMID:Antibiotic prophylaxis against streptomycin-resistant and -susceptible Streptococcus faecalis endocarditis in rabbits. 641 63

The in vitro and in vivo activities of mezlocillin and ampicillin, alone and in combination with gentamicin, against Streptococcus faecalis were compared. In vitro, relative bactericidal and activities for 10 strains of S. faecalis were as follows: mezlocillin plus gentamicin greater than ampicillin plus gentamicin (P is not significant) greater than mezlocillin (P less than 0.01) greater than ampicillin (P less than 0.01) greater than gentamicin (P less than 0.01) greater than control (P less than 0.01). One of the strains was used to induce endocarditis in rabbits. Infected rabbits were treated by random selection with ampicillin, mezlocillin, ampicillin plus gentamicin, mezlocillin plus gentamicin, or saline (control) for 7 days. Among antibiotic-treated rabbits, survival rates were the same, but ampicillin was less effective than the other regimens in sterilizing both blood cultures (P less than 0.001 on day 4) and cardiac vegetations (P less than 0.05 on day 7). Differences in quantitative vegetation cultures among rabbits treated with mezlocillin, mezlocillin plus gentamicin, or ampicillin plus gentamicin and sacrificed on day 7 were not significantly different. Peak inhibitory and bactericidal antibacterial activity titers in serum determined during treatment were higher with mezlocillin (with or without gentamicin) than with ampicillin (with or without gentamicin) (P less than 0.01). Mezlocillin may be more effective than ampicillin in the treatment of S. faecalis infections in humans.
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PMID:Comparative efficacies of mezlocillin and ampicillin alone or in combination with gentamicin in the treatment of Streptococcus faecalis endocarditis in rabbits. 642 6


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