What’s New in the Treatment of Enterococcal Endocarditis?

  • Masayuki Nigo
  • Jose M. Munita
  • Cesar A. Arias
  • Barbara E. MurrayEmail author
Cardiovascular Infections (D Levine, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardiovascular Infections


Enterococcus spp. are among the common pathogens causing infective endocarditis (IE). Despite major medical advances and new potent antimicrobial agents, the mortality has not significantly improved for several decades. The usual lack of bactericidal activity of penicillin or ampicillin, the toxicity from the combination of penicillin plus aminoglycosides, and the increased reports of high-level resistance to aminoglycosides have led to the exploration of other regimens for treatment of Enterococcus faecalis IE. As an example, ampicillin plus ceftriaxone is now a well-recognized regimen for this organism. However, the emerging of new drug resistances in Enterococcus faecium dramatically reduces the therapeutic alternatives for this organism in IE which continues to be an immense challenge for clinicians even with the availability of newer antimicrobial agents. This article summarizes the current treatment options for enterococcal endocarditis and reviews of recent publications on the topic.


Endocarditis Enterococcal Enterococci VRE Enterococcus 


Compliance with Ethics Guidelines

Conflict of Interest

Dr. Murray reports grants from Johnson & Johnson, grants from Cubist, grants and personal fees from Theravance, grants from Forest, personal fees and non-financial support from Rib-X, personal fees and non-financial support from Durata Therapeutics, personal fees and non-financial support from Achaogen, personal fees and non-financial support from The Medicines Co., personal fees and non-financial support from GlaxoSmithKline. Dr. Arias reports grants and consulting fees from Pfizer, grants from Forest Pharmaceuticals, grants and consulting fees from Theravance Inc., consulting fees from Novartis, consulting fees from Cubist and consulting fees from Astra Zeneca and he has served as a speaker for Pfizer, Forest Pharmaceutics, Novartis, Cubist and Astra Zeneca. Drs. Nigo and Munita have not conflicts of interest to declare.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Masayuki Nigo
    • 1
  • Jose M. Munita
    • 1
    • 4
  • Cesar A. Arias
    • 1
    • 2
    • 3
  • Barbara E. Murray
    • 1
    • 2
    • 5
    Email author
  1. 1.Division of Infectious Diseases, Department of Internal MedicineUniversity of Texas Medical School at HoustonHoustonUSA
  2. 2.Department of Microbiology and Molecular GeneticsUniversity of Texas Medical School at HoustonHoustonUSA
  3. 3.Molecular Genetics and Antimicrobial Resistance UnitUniversidad El BosqueBogotáColombia
  4. 4.Clinica Alemana de Santiago, Universidad del DesarrolloSantiagoChile
  5. 5.University of Texas Medical School at HoustonHoustonUSA

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