THE TREATMENT OF BACTERIAL ENDOCARDITIS

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Abstract
An analysis of 138 instances of bacterial endocarditis is presented, representing the total experience in the Duke Hospital from 1930 to 1947. From 1930 to 1937 in the presulfonamide period, one of 41 patients survived following autogenous vaccine therapy. From 1938 to 1943, 41 patients were given sulfonamide therapy. Four patients survived, 2 with sulfonamide therapy alone and 2 with additional typhoid "H" antigen fever therapy. In 1944, 4 of 12 patients recovered after small-dose penicillin therapy. From 1945 to July, 1947, 16 of 25 patients recovered after the admn. of larger doses of penicillin. The pertinent literature is reviewed. Discussion is offered regarding daily and total penicillin dosage, modes of admn., and causes of treatment failure. Bacterial endocarditis remains a fatal disease in a significant percentage of cases.