Cristina Popescu *, G. Popescu *, Anișoara Macarei *
* Dr. Cristina Popescu – asistent universitar; Dr. Gabriel Popescu – asistent universitar; Dr. Anișoara Macarei – medic stagiar – Clinica I Boli Infecțioase Colentina, UMF “Carol Davila” București
Abstract
Staphilococci cause at least 20 – 30% of the cases of infective endocarditis (IE), and 80 – 90% of these are due to coagulase-pozitive S. aureus. The current recommended regimen for IE with meticilin-sensitives staphilococci includes a penicillinase-resistant penicillin (Nafcilin , Oxacilin or Cloxacilin) given for 4 – 6 weeks with the addition of an aminoglycozid for 1 week. Recently, short therapy (2 weeks) with same antibiotics is indicated in right-sided IE without evidence of renal failure or extrapulmonary metastatic infectious complications. Vancomycin is less rapidly bactericidal than penicillinase-resistent penicillins, and is indicated in patients with allergy to beta-lactams . For IE with meticilin-resistants staphilococci vancomicin is formerly indicated , in association with another antistaphylococcal agent. In right-sided IE persistent infection and pulmonary trombembolism is the indication for surgery in over 70% of the patients; procedures are tricuspid valvulectomy or «vegetectomy», less frequent valve replacement or valvular reconstruction.