Cited by 196Infective Endocarditis Diagnosis and ManagementStreptococcal Infections and TreatmentsAntibiotics Pharmacokinetics and Efficacy

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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

Sexton, Daniel J., Tenenbaum, Marvin J., Wilson, Walter R., Steckelberg, James M., Tice, Alan D., Gilbert, David, Dismukes, William, Drew, Richard H., Durack, David T., Endocarditis Treatment Consortium Group·1998·Clinical Infectious Diseases

DOI 10.1086/515038

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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.
ORCID: Sexton, Daniel J.
Gilbert, David
Drew, Richard H.
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
DOI: 10.1086/515038
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 › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
Health Sciences › Medicine › Pharmacology (medical) › 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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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

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