Speculations on the Mechanism of Cure of Bacterial Endocarditis

It is now common experience that subacute bacterial endocarditis can usually be cured, at least as far as the infection is concerned, by prolonged and intensive treatment with penicillin. Nevertheless several problems related to the control of this infection still remain. A significant number of patients, especially those harboring enterococci in the vegetations, prove refractory to the usual course of therapy. Furthermore, the generally recommended treatment of four to eight weeks is both costly and inconvenient. It would certainly be an advance if a more rapid and a sure means of eradicating this infection could be found. Several antibiotics besides penicillin are now available, and many of them (including streptomycin, aureomycin, chloramphenicol [chloromycetin®] and terramycin) have some activity against the nonhemolytic streptococci. The role of these drugs both singly and in various combinations in the treatment of bacterial endocarditis needs to be evaluated. It therefore seems appropriate to examine