ANTIBIOTIC TREATMENT OF BACTERIAL ENDOCARDITIS DUE TO ENTEROCOCCUS: Presentation of a Case and in Vitro Studies That Show a Potentiating Effect of Erythromycin, Chlortetracycline, and Streptomycin on Some Strains of Enterococci

THE EXCELLENT studies of Hunter,¹ Robbins and Tompsett,2 and Cates, Christie, and Garrod³ have established that the combination of penicillin and streptomycin is an effective treatment for most cases of bacterial endocarditis due to Enterococcus (Streptococcus faecalis, Group D Streptococcus). However, since all cases of enterococcal endocarditis do not respond to these antibiotics,* this report concerns a case that was cured with the combination of erythromycin, chlortetracycline, and streptomycin. These antibiotics were selected on the basis of in vitro studies of the causative bacteria. Data showing that erythromycin, chlortetracycline, and streptomycin are effective against other strains of enterococci also are presented. It is suggested on the basis of these findings that if penicillin and streptomycin are not effective in a case of enterococcal endocarditis, the combination of erythromycin, chlortetracycline, and streptomycin might be of value.

REPORT OF A CASE  The patient was a 27-year-old white married woman