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Penicillin Hypersensitivity in Patients with Bacterial Endocarditis

MICHAEL H. GRIECO, M.D.; MICHAEL R. DUBIN, M.D.; JOHN L. ROBINSON, M.D.; and MILES J. SCHWARTZ, M.D., F.A.C.P.
Ann Intern Med. 1964;60(2_Part_1):204-216. doi:10.7326/0003-4819-60-2-204
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This excerpt has been provided in the absence of an abstract.

Since its discovery, penicillin has remained the antibiotic of choice for the treatment of bacterial endocarditis. This disorder requires therapy with bacteriocidal agents, for the literature is replete with reports of the inefficiency of bacteriostatic drugs (1). Thus the physician who must manage a penicillin-sensitive patient afflicted with bacterial endocarditis is faced with a major dilemma. In our experience this problem is not infrequent.

The treatment of bacterial endocarditis in patients allergic to penicillin receives only superficial mention in the medical literature. Some articles propose solutions to this problem, which are wholly inaccurate. Others reflect a basic misunderstanding of penicillin

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