What’s New in the Treatment of Enterococcal Endocarditis?

Abstract

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.

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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.

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Correspondence to Barbara E. Murray.

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This article is part of the Topical Collection on Cardiovascular Infections

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Nigo, M., Munita, J.M., Arias, C.A. et al. What’s New in the Treatment of Enterococcal Endocarditis?. Curr Infect Dis Rep 16, 431 (2014). https://doi.org/10.1007/s11908-014-0431-z

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Keywords

  • Endocarditis
  • Enterococcal
  • Enterococci
  • VRE
  • Enterococcus