Endocarditis Due to Resistant Viridans Streptococci during Oral Penicillin Chemoprophylaxis

作者：Joseph E. Parrillo, George C. Borst, Mark H. Mazur, Paul B. Iannini, Mark S. Klempner, Robert C. Moellering, Seth E. Anderson · 发表于：New England Journal of Medicine · 年份：1979 · DOI：10.1056/nejm197902083000608 · 被引用次数：85 · 研究领域：Infective Endocarditis Diagnosis and Management、Streptococcal Infections and Treatments、Otolaryngology and Infectious Diseases

OPTIMAL management of patients with rheumatic heart disease or a previous bout of acute rheumatic fever includes the administration of prophylactic antibiotics to prevent pharyngeal infection with Group A streptococci.1 , 2 Several studies have shown that oral penicillin prophylaxis is associated with a high prevalence of penicillin-resistant bacteria in the gingival flora.3 4 5 6 7 8 9 An original concern was that continuous low-dose prophylaxis would result in a high incidence of endocarditis due to resistant organisms that would be difficult to cure. Follow-up studies of large numbers of patients taking prophylactic penicillin have found no increase in the incidence of endocarditis,10 and few cases of . . .