Streptococcal endocarditis (nonenterococcal, non-group A): single vs combination therapy

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Abstract
A 14-yr experience with streptococcal endocarditis was reviewed. The effect of single vs. combination antibiotic therapy on the relapse rate was comparable. Of 68 patients treated, 4 patients died during therapy. Two of 46 patients receiving single-agent and none of 18 patients receiving combination therapy experienced a relapse. Duration of symptoms before diagnosis was the main risk factor predisposing to relapse, which occurred in 2 of 13 patients with symptoms for longer than 3 mo. and in none of 51 patients with symptoms for 3 mo. or less before diagnosis. Combination therapy offered no advantage over a single agent in the latter group. Optimal therapy for patients with symptoms for longer than 3 mo. could not be determined in this study. No relapses were observed in this high-risk group when a single agent was given for longer than 21 days.

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