Ampicillin plus Ceftriaxone for High-Level Aminoglycoside-Resistant <i>Enterococcus faecalis</i> Endocarditis
Authors: Akashdeep Singh
Journal: Annals of Internal Medicine (2008)

Letters5 February 2008Ampicillin plus Ceftriaxone for High-Level Aminoglycoside-Resistant Enterococcus faecalis EndocarditisAkashdeep Singh, MD, DMAkashdeep Singh, MD, DMFrom Christian Medical College and Hospital, Ludhiana, India 141008.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-3-200802050-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The antimicrobial synergism of ampicillin plus ceftriaxone to treat high-level aminoglycoside-resistant (HLAR) Enterococcus faecalis endocarditis, as shown by Gavaldà and colleagues (1), is important. However, certain basic questions need to be answered before this treatment can be incorporated into everyday practice. First, enterococci are inherently resistant to cephalosporins, including ceftriaxone. Second, ampicillin and ceftriaxone are both β-lactam antibiotics with a common mechanism of action: inhibition of synthesis of the bacterial peptidoglycan cell wall. Antimicrobial agents acting on different targets may enhance the overall antimicrobial activity. How then can there be synergism between these 2 drugs? Treatment of ...References1. Gavaldà J, Len O, Miró JM, Muñoz P, Montejo M, Alarcón A, et al. Brief communication: treatment of Enterococcus faecalis endocarditis with ampicillin plus ceftriaxone. Ann Intern Med. 2007;146:574-9. [PMID: 17438316] LinkGoogle Scholar2. Caron F, Pestel M, Kitzis MD, Lemeland JF, Humbert G, Gutmann L. Comparison of different beta-lactam-glycopeptide-gentamicin combinations for an experimental endocarditis caused by a highly beta-lactam-resistant and highly glycopeptide-resistant isolate of Enterococcus faecium. J Infect Dis. 1995;171:106-12. [PMID: 7798650] CrossrefMedlineGoogle Scholar3. Hoen B, Alla F, Selton-Suty C, Béguinot I, Bouvet A, Briançon S, et al; Association pour l'Etude et la Prévention de l'Endocardite Infectieuse (AEPEI) Study Group. Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA. 2002;288:75-81. [PMID: 12090865] CrossrefMedlineGoogle Scholar4. Eliopoulos GM. Aminoglycoside resistant enterococcal endocarditis. Infect Dis Clin North Am. 1993;7:117-33. [PMID: 8463648] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Akashdeep Singh, MD, DMAffiliations: From Christian Medical College and Hospital, Ludhiana, India 141008.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIncorporating Quality of Evidence into Decision Analytic Modeling R. Scott Braithwaite , Mark S. Roberts , and Amy C. Justice Brief Communication: Treatment of Enterococcus faecalis Endocarditis with Ampicillin plus Ceftriaxone Joan Gavaldà , Oscar Len , José M. Miró , Patricia Muñoz , Miguel Montejo , Aristides Alarcón , Julián de la Torre-Cisneros , Carmen Peña , Xavier Martínez-Lacasa , Cristina Sarria , Germán Bou , José M. Aguado , Enrique Navas , Joan Romeu , Francesc Marco , Carmen Torres , Pilar Tornos , Ana Planes , Vicenç Falcó , Benito Almirante , and Albert Pahissa Ampicillin plus Ceftriaxone for High-Level Aminoglycoside-Resistant Enterococcus faecalis Endocarditis Joan Gavaldá , Oscar Len , Benito Almirante , and Albert Pahissa Metrics Cited byAmpicillin Mineralization by Denitrifying Process: Kinetic and Metabolic EffectsGuidelines for the diagnosis and antibiotic treatment of endocarditis in adults: a report of the Working Party of the British Society for Antimicrobial Chemotherapy 5 February 2008Volume 148, Issue 3Page: 243KeywordsAntibioticsAntimicrobialsAttentionCell wallsConflicts of interestDrugsEndocarditisEnterococcus faecalisStreptomycinTherapeutic drug monitoring ePublished: 5 February 2008 Issue Published: 5 February 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...