THERAPEUTIC PRINCIPLES FOR STREPTOCOCCUS VIRIDANS INFECTIONS: RECURRENT BACTERIAL ENDOCARDITIS IN A CHILD WITH CONGENITAL HEART DISEASE

Abstract

A case of recurrent bacterial endocarditis due to a relatively resistant alpha streptococcus is reviewed. The following general principles of treatment are recommended: 1. Intravenous penicillin therapy should be instituted in all instances. 2. Should serum bactericidal levels indicate the organism to be extremely sensitive (< 0.1 units/ml) oral phenoxymethyl penicillin (Penicillin-V) may be substituted after 3 weeks. 3. In cases infected with organisms sensitive to greater than 0.1 units/ml, intravenous therapy should be continued for 6 weeks and streptomycin added for 2 weeks. 4. When facilities for studying penicillin sensitivity and serum bactericidal activity are not available, the intravenous penicillin-streptomycin regime is recommended.