Single or Combination Therapy of Staphylococcal Endocarditis in Intravenous Drug Abusers

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Abstract
Staphylococcus aureus is the commonest cause of acute endocarditis in i.v. drug abusers. In vitro and in-vivo animal studies found increased killing of organisms with the combination of a .beta.-lactam antibiotic and an aminoglycoside. These findings created a controversy about the use of such combination therapy. Episodes of S. aureus endocarditis (25) in i.v. drug abusers were treated with single or combination antibiotic regimens. Mean days to defervescence were similar in both groups. There were no bacteriologic failures or relapses in either group. No patients needed valvular surgery and the mortality rate was zero. Single drug therapy with an appropriate .beta.-lactam antibiotic is adequate and appropriate in i.v. drug abusers with S. aureus endocarditis.