Ampicillin plus ceftriaxone therapy against Enterococcus faecalis endocarditis: A case report, guidelines considerations, and literature review

Andrea Marino, Antonio Munafò, Aldo Zagami, Manuela Ceccarelli, Edoardo Campanella, Federica Cosentino, Vittoria Moscatt, Giuseppina Cantarella, Rosaria Di Mauro, Renato Bernardini, Giuseppe Nunnari, Bruno Cacopardo, Andrea Marino, Antonio Munafò, Aldo Zagami, Manuela Ceccarelli, Edoardo Campanella, Federica Cosentino, Vittoria Moscatt, Giuseppina Cantarella, Rosaria Di Mauro, Renato Bernardini, Giuseppe Nunnari, Bruno Cacopardo

Abstract

Enterococcus faecalis infective endocarditis (EFIE) continues to be a very serious disease, showing considerable morbidity and mortality rates which are influenced by the spread of multi-drug resistant strains occurred in the last decades. Although aminoglycosides were considered the treatment of choice of EIFE, in recent years several studies have investigated alternative therapeutic approaches, including combinations of beta-lactams, mainly because of the aminoglycoside-renowned nephrotoxicity and the widespread development of high-level aminoglycosides resistance (HLAR). In this scenario, we reported a case involving a prosthetic valve infective endocarditis caused by an aminoglycoside-resistant E. faecalis strain which was successfully treated with ampicillin plus ceftriaxone despite the presence of artificial heart valve and the patient's severe clinical conditions.

Keywords: Ampicillin plus ceftriaxone; Antibiotics resistance; Double beta-lactams therapy; Enterococcus faecalis; Infective endocarditis.

Conflict of interest statement

The authors declare no conflict of interest.

© 2022 The Authors.

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