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Combination Antimicrobial Therapy for Staphylococcus aureus Endocarditis in Patients Addicted to Parenteral Drugs and in Nonaddicts: A Prospective Study

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▸Requests for reprints should be addressed to Merle A. Sande, M.D.; San Francisco General Hospital, 5H22, 1001 Potrero Avenue; San Francisco, CA, 94110.

THE NATIONAL COLLABORATIVE ENDOCARDITIS STUDY GROUP*; Charlottesville, Virginia; Philadelphia, Pennsylvania; and San Francisco, California

© 1982 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1982;97(4):496-503. doi:10.7326/0003-4819-97-4-496
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Single (nafcillin for 6 weeks) and combined (nafcillin for 6 weeks plus gentamicin for 2 weeks) drug regimens were compared in two separate multicenter prospective randomized trials. Forty-eight parenteral drug addicts and 30 nonaddicts with clinically and bacteriologically documented Staphylococcus aureus endocarditis were studied. In the addicts, combined therapy effected a more rapid mean clinical response (defervescence and normalization of leukocyte count) and a reduced duration of bacteremia in patients with right-sided endocarditis. In the nonaddicts, combined therapy effected more rapid clearance of bacteremia, but was associated with a higher incidence of azotemia. The addition of gentamicin did not alter morbidity or mortality in either group.





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