Journal
EXPERT REVIEW OF CARDIOVASCULAR THERAPY
Volume 11, Issue 9, Pages 1247-1257Publisher
TAYLOR & FRANCIS INC
DOI: 10.1586/14779072.2013.832482
Keywords
ampicillin; antibiotic resistance; ceftriaxone; enterococcus facalis; gentamicin; health care associated; infective endocarditis; mortality; relapse; treatment
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Funding
- Danish Heart Foundation
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Enterococcus faecalis infective endocarditis (IE) is a disease of increasing importance, with more patients infected, increasing frequency of health-care associated infections and increasing incidence of antimicrobial resistances. The typical clinical presentation is a subacute course with fever, malaise and generalized aches, difficult to distinguish from other more common diseases. Of paramount importance is transthoracic-and transesophageal-echocardiography to establish the diagnosis. At the moment, the predominant strategies recommend ampicillin in combination with either gentamicin or ceftriaxone. E. faecalis infective endocarditis continues to be a very serious disease with considerable percentages of high-level gentamicin resistant strains and in-hospital mortality around 20%. Strategies to prevent E. faecalis IE, improve diagnostics, optimize treatment and reduce morbidity will be necessary to improve the overall prognosis.
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