New cutoffs to define penicillin-susceptible (MIC s 0.125 mg/L), intermediate resistant (MIC025-2 mg/L) and resistant (MIC> 4 mg/L) streptococci R New cutoffs to define penicillin-susceptible (MICs0.06 mg/L), intermediate resistant (MIC 0.125-2 mg/L), and resistant (MIC 24 mg/L) pneumococcal strains Ceftriaxone is an option in endocarditis caused by relatively penicillin resistant (MIC 0.125-2 mg/L) oral streptococci and the Streptococcus bovis group, preferably by outpatient administration Desensitization in patients with methicillin-susceptible aureus endocarditis and allergy to beta lactams High-dose vancomycin for staphylococcal endocarditis: 30-60 mg/kg/d, divided into 2-3 doses (trough level 220 mg/L) High-dose daptomycin to treat S aureus endocarditis in patients allergic to penicillin and infections caused by methicillin-resistant strainsb Rifampicin for prosthetic valve endocarditis following 3-5 d of effective treatment at a lower dose (900-1200 mg/d, divided into 2-3 doses) six weeks' duration of endocarditis therapy for prosthetic valve infection due to HACEK group microorganisms Doxycycline and hydroxychloroquine for Coxiella bumetii(Qfever) endocarditis High-dose echinocandins to treat endocarditis due to Candida spp. Voriconazole (combined or not with echinocandins or amphotericin B) to treat endocarditis caused by Aspergillus New initial empirical therapy regimen for native valve infection: ampicillin, cloxacillin, and gentamicin
This combination enables treatment of all cases of E faecalis endocarditis with no ris f toxicity and regardless of the degree ofaminoglycoside resistance. Administration with a second antibiotic is proposed to increase the activity and avo he emergence of resistance.