Treatment of Streptococcal Endocarditis with a Single Daily Dose of Ceftriaxone and Netilmicin for 14 Days: A Prospective Multicenter Study
Open accessAbstract
A 2-week course of ceftriaxone (2 g) plus netilmicin (4 mg/kg), administered as one short daily iv infusion, was evaluated for the treatment of streptococcal endocarditis in an open multicenter study. Of the 52 patients, 31 were infected with viridans streptococci, 18 with Streptococcus bovis, two with Gemella morbillorum, and one with group C Streptococcus; 48 patients were assessable. Infection was cured in 42 cases, 35 treated medically and seven treated both medically and surgically. Five patients died without evidence of active infection, and one relapsed. The bacteriologic failure was due to a strain of G. morbillorum against which no synergy of ceftriaxone and netilmicin was evident in vitro. The serum creatinine level increased during treatment in four cases, all involving patients > 65 years old who had renal risk factors; in two of these cases, values did not return to baseline during follow-up. Of 40 patients assessed for auditory function, only one developed decreased perception of borderline significance. Other adverse reactions were mild. This regimen was efficacious, safe, and cost-effective for the treatment of streptococcal endocarditis. However, it must be used with caution for patients with preexisting renal impairment or concomitant exposure to other potentially nephrotoxic agents.
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Combination therapy with penicillin or ceftriaxone and an aminoglycoside for 2 weeks is highly effective in viridans group streptococci (VGS) IE in very select patients with uncomplicated infection.
“Combination therapy with penicillin or ceftriaxone and an aminoglycoside for 2 weeks is highly effective in viridans group streptococci (VGS) IE 90 in very select patients with uncomplicated infection.”
The lower bacterial densities in right-sided vegetations may result from host defense mechanisms, including polymorphonuclear activity or platelet-derived antibacterial cationic peptides.
“Of interest, right-sided vegetations tend to have lower bacterial densities, which may result from host defense mechanisms, including polymorphonuclear activity or plateletderived antibacterial cationic peptides.90,91,93”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [90]
The Results describe the infected valves and organisms in this treatment study, but do not compare bacterial densities in right- and left-sided vegetations. The Discussion addresses antibiotic efficacy, not polymorphonuclear activity or platelet-derived antibacterial peptides; searches for those mechanisms found no supporting passage. Page numbers were unavailable in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredRight-sided vegetations tend to have lower bacterial densities.
“Of interest, right-sided vegetations tend to have lower bacterial densities, which may result from host defense mechanisms, including polymorphonuclear activity or plateletderived antibacterial cationic peptides.90,91,93”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [90]
The Results describe valve involvement and vegetations, but do not compare bacterial densities in right- and left-sided vegetations. Searches for that comparison and for the proposed host-defense mechanisms found no passage addressing either point in our copy. (LLM, conf=0.77)
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Cites
Durack, D. T., Lukes, A. S., Bright, D. K., & Service, D. E. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90143-0 · Cited by 2,572 · see citing works
Once versus thrice daily gentamicin in patients with serious infections
Prins, J. M., Büller, H. R., Speelman, P., et al. (1993) · The Lancet · doi:10.1016/0140-6736(93)90137-6 · Cited by 351 · see citing works
Bisno, A. L. (1989) · JAMA · doi:10.1001/jama.1989.03420100107033 · Cited by 165 · see citing works
ter Braak, E. W. M. T., de Vries, P. J., Bouter, K. P., et al. (1990) · The American Journal of Medicine · doi:10.1016/0002-9343(90)90099-y · Cited by 150 · see citing works
Pharmacokinetic profile of ceftriaxone in man.
Patel, I. H., & Kaplan, S. A. (1984) · PubMed · Cited by 128 · see citing works
Antibiotic Management of Outpatients with Endocarditis Due to Penicillin-Susceptible Streptococci
Stamboulián, D., Bonvehí, P., Arévalo, C. E., Bologna, R., Cassetti, I., Scilingo, V. M., & Efrón, E. (1991) · Clinical Infectious Diseases · doi:10.1093/clinids/13.supplement_2.s160 · Cited by 126 · see citing works
Wilson, W. R. (1981) · JAMA · doi:10.1001/jama.245.4.360 · Cited by 121 · see citing works
Francioli, P. (1992) · JAMA · doi:10.1001/jama.1992.03480020074034 · Cited by 98 · see citing works
Self-citationFantin, B., & Carbon, C. (1990) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.34.12.2387 · Cited by 76 · see citing works
Treatment of streptococcal infective endocarditis
Wilson, W. R., & GERACI, J. E. (1985) · The American Journal of Medicine · doi:10.1016/0002-9343(85)90375-4 · Cited by 62 · see citing works
CEFTRIAXONE AND OUTPATIENT TREATMENT OF INFECTIVE ENDOCARDITIS
Francioli, P. B. (1993) · Infectious Disease Clinics of North America · doi:10.1016/s0891-5520(20)30508-0 · Cited by 57 · see citing works
Self-citationHessen, M. T., Pitsakis, P. G., & Levison, M. E. (1989) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.33.5.608 · Cited by 56 · see citing works
A prospective study of neutropenia induced by high doses of β-lactam antibiotics
Olaison, L., & Alestig, K. (1990) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/25.3.449 · Cited by 47 · see citing works
Infective endocarditis 2nd edition
Oakley, C. M. (1993) · International Journal of Cardiology · doi:10.1016/0167-5273(93)90259-j · Cited by 34 · see citing works
Francioli, P. B., & Glauser, M. P. (1993) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.37.2.207 · Cited by 33 · see citing works
Self-citationBlatter, M., Flückiger, U. M., Entenza, J. M., Glauser, M. P., & Francioli, P. B. (1993) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.37.9.1971 · Cited by 28 · see citing works
Self-citationCeftriaxone Sodium Therapy of Penicillin G—Susceptible Streptococcal Endocarditis
Wilson, W. R. (1992) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1992.03480020089038 · Cited by 19 · see citing works
Bisno, A. L. (1989) · JAMA · doi:10.1001/jama.261.10.1471 · Cited by 19 · see citing works
Evaluation of New Anti-Infective Drugs for the Treatment of Infective Endocarditis
Wilson, W. R., Gilbert, D. N., Bisno, A. L., Freedman, L. R., Smith, C., Drusano, G. L., & Kaye, D. (1992) · Clinical Infectious Diseases · doi:10.1093/clind/15.supplement_1.s89 · Cited by 15 · see citing works
Metsenaere, R. E. A. S. D. (1991) · Springer eBooks · doi:10.1007/978-94-009-2075-0_7 · Cited by 13 · see citing works
Ceftriaxone sodium therapy of penicillin G-susceptible streptococcal endocarditis
Wilson, W. R. (1992) · JAMA · doi:10.1001/jama.267.2.279 · Cited by 6 · see citing works
Shanson, D. C., Tadayon, M., & Bakhtiar, M. (1986) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/18.4.479 · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- [2]2. Wilson WR, Thompson RL, Wilkowske CJ, et al. Short-term therapy for streptococcal infective endocarditis. JAMA 1981;245:360-3.
- [7]7. Van der Auwera P, Meunier F, Ibrahim S, Kaufman L, Derde MP, Tulkens PM. Pharmacodynamic parameters of toxicity of netilmicin (6 milli- grams/kilogram/day) given once daily or in three divided doses to cancer em 1995;21 (December) patients with urinary tract infection. Antimicrob Agents Chemother 1991;35:4640-7.
- [9]9. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer. Efficacy and toxic- ity of single daily doses of amikacin and ceftriaxone vs multiple daily doses of amikacin and ceftazidime for infection in patients with cancer and granulocytopenia. Ann Intern Med 1993; 119:584-93.
- [11]11. Saleh-Mghir A, Cremieux AC, Vallois JM, Muffat-Joly M, Devine C, Carbon C. Optimal aminoglycoside dosing regimen for penicillin-tobra- mycin synergism in experimental streptococcus adjacent endocarditis. Antimicrob Agents Chemother 1992;36:2403-7.
- [13]13. Gavalda J, Pahissa A, Almirante B, et al. Efficacy of gentamicin once a day in the treatment of viridans streptococcal experimental endocarditis [abstract no 1449]. In: Program and abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy (Anaheim). Washington, DC: American Society for Microbiology, 1992.
- [16]16. Patel IH, Kaplan SA. Pharmacokinetic profile of ceftriaxone. Am J Med 1984;77:17-25.
Cited by
Sorted by citations
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., Barsic, B., Lockhart, P. B., Gewitz, M. H., Levison, M. E., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000296 · Cited by 3,232 · see citing works
Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009)
Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and by the International Society of Chemotherapy (ISC) for Infection and Cancer, Habib, G., Hoen, B., Tornos, P., Thuny, F., Prendergast, B., Vilacosta, I., Moreillon, P., de Jesus Antunes, M., Thilen, U., et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp285 · Cited by 2,014 · see citing works
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Bolger, A. F., Levison, M. E., Ferrieri, P., Gerber, M. A., Tani, L. Y., Gewitz, M. H., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.165564 · Cited by 1,707 · see citing works
Intrinsic and acquired resistance mechanisms in enterococcus
Hollenbeck, B. L., & Rice, L. B. (2012) · Virulence · doi:10.4161/viru.21282 · Cited by 795 · see citing works
Wilson, W. R. (1995) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1995.03530210060032 · Cited by 492 · see citing works
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 (1998) · Clinical Infectious Diseases · doi:10.1086/515038 · Cited by 195 · see citing works
Andrews, M., & von Reyn, C. F. (2001) · Clinical Infectious Diseases · doi:10.1086/321814 · Cited by 129 · see citing works
Outpatient management of infective endocarditis
Monteiro, C.-A., & Cobbs, C. G. (2001) · Current Infectious Disease Reports · doi:10.1007/s11908-001-0068-6 · Cited by 26 · see citing works
- Authors
- Francioli, P., Ruch, W., Stamboulian, D., & International Infective Endocarditis Study Group
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- F. Hoffmann-La Roche AG (CH)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1995-12-01
- Volume
- 21
- Issue
- 6
- Pages
- 1406-1410
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2095331130
- Semantic Scholar
- 79f4c87ce8dda933b8840f885b4cde0df0d0360d
- Cited by
- 147
- References
- 22
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 2 · 2015: 8 · 2014: 1 · 2013: 4 · 2012: 3
- FWCI
- 6.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- reroDoc Digital Library (submittedVersion)
- IRIS (submittedVersion)
- 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
- streptococcal endocarditis, ceftriaxone, netilmicin, Streptococcus viridans, Streptococcus bovis, Gemella morbillorum, group C streptococci, combination antibiotic therapy, nephrotoxicity, serum creatinine, hearing loss, cost-effectiveness
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Ceftriaxone, Drug Therapy, Combination, Endocarditis, Bacterial, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netilmicin, Prospective Studies, Streptococcal Infections, Treatment Outcome
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