Ceftriaxone Once Daily for Four Weeks Compared with Ceftriaxone Plus Gentamicin Once Daily for Two Weeks for Treatment of Endocarditis Due to Penicillin-Susceptible Streptococci
Abstract
This randomized, multicenter, open-label study compared the efficacy and safety of monotherapy with 2 g of intravenous ceftriaxone once daily for 4 weeks with those of combination therapy with 2 g of intravenous ceftriaxone and 3 mg of intravenous gentamicin/kg once daily for 2 weeks as therapy for endocarditis due to penicillin-susceptible streptococci. Sixty-one patients were enrolled in the study. Clinical cure was observed for 51 evaluable patients both at termination of therapy and at the 3-month follow-up: 25 (96.2%) of 26 monotherapy recipients and 24 (96%) of 25 combination therapy recipients. Of the 23 patients in each treatment group who were microbiologically evaluable, 22 (95.7%) in each group were considered cured. No patient had evidence of relapse. Fourteen patients (27.5%) required cardiac surgery after initiation of treatment, including five monotherapy recipients and nine combination therapy recipients. Adverse effects were minimal in both treatment groups. We conclude that 2 g of ceftriaxone once daily for 4 weeks and 2 g of ceftriaxone in combination with 3 mg of gentamicin/kg once daily for 2 weeks are both effective and safe for the treatment of streptococcal endocarditis.
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- Authors
- Sexton, D. J., Tenenbaum, M. J., Wilson, W. R., Steckelberg, J. M., Tice, A. D., Gilbert, D., Dismukes, W., Drew, R. H., Durack, D. T., & Endocarditis Treatment Consortium Group
- Affiliations
- Duke Medical Center (US)
- Mayo Clinic (US)
- Corresponding author
- Sexton, Daniel J.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-12-01
- Volume
- 27
- Issue
- 6
- Pages
- 1470-1474
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W1976043895
- Semantic Scholar
- 048ac2cb5b05b0d8ad8cedd6c53ecd0245719ee6
- Cited by
- 195
- References
- 16
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 1 · 2021: 2 · 2020: 8 · 2019: 5 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 9 · 2014: 5 · 2013: 3 · 2012: 3
- FWCI
- 5.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
- Keywords
- ceftriaxone, gentamicin, streptococcal endocarditis, antibiotic monotherapy, combination antibiotic therapy, intravenous antibiotics, treatment efficacy, treatment safety, cardiac surgery
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Ceftriaxone, Cephalosporins, Drug Therapy, Combination, Endocarditis, Bacterial, Gentamicins, Humans, Middle Aged, Penicillins, Streptococcal Infections, Streptococcus
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