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Ampicillin in the Treatment of Enterococcal Endocarditis

Ann Intern Med. 1966;65(4):701-707. doi:10.7326/0003-4819-65-4-701
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The currently recommended treatment for enterococcal endocarditis consists of high doses of aqueous penicillin intravenously, given in combination with intramuscular streptomycin for 6 weeks (1). If antibiotic dosage is regulated to maintain a constant bactericidal activity against the infecting strain in at least a 1:4 dilution of the patient's serum, the bacteriologic cure rate for this infection approaches that achieved for highly penicillin-sensitive Streptococcus viridans endocarditis (1, 2). Although the penicillin-streptomycin regimen is eminently satisfactory from the therapeutic point of view, it involves considerable inconvenience, cost, and the potential risk of ototoxicity. For these reasons, it seems reasonable to seek


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