Penicillin Hypersensitivity in Patients with Bacterial Endocarditis

Publisher Website
Google Scholar
Abstract
The treatment of penicillin sensitivity complicating bacterial endocarditis has received only superficial mention in the medical literature. The authors have encountered 10 such problems in 100 cases of bacterial endocarditis since 1945. Immediate hypersensitivity is unpredictable. The most reliable warning is a past history of penicillin reaction. A positive immediate skin test signals likely anaphylaxis while a negative response precludes neither anaphyl-axis nor other serious allergic reactions. It is generally thought that patients suffering from bacterial endocarditis require penicillin even though they may be sensitive to it. In such cases desensitization to penicillin has been attempted and frequently antihistamines or glucocorticoids have been administered simultaneously as prophylactic medication. Results have been inconclusive. Certain antibiotics and combinations offer cure almost as reliably as penicillin and streptomycin. Good results have been obtained with erythromycin and streptomycin in Streptococcus viridans endocarditis. Ristocetin and vancomycin appear equally promising for treatment of enterococcic and staphylococcic injections, respectively.