Successful treatment of prosthetic valve endocarditis using rifampicin and benzylpenicillin in combination with valve replacement.

JMM Case Rep

Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia; Centre for Research Excellence in Critical Infections, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia.

Published: February 2017

is an uncommon cause of prosthetic valve endocarditis (PVE). Recommended antimicrobial therapy typically includes intravenous β-lactams with or without synergistic aminoglycosides. studies have previously identified antagonism when rifampicin has been used in combination with β-lactams. However, data of rifampicin use are limited despite its enhanced anti-biofilm activity. A 63-year-old male presented with fever and back pain. bacteraemia and bioprosthetic aortic valve endocarditis was confirmed, along with spinal discitis and osteomyelitis. He was successfully treated with benzylpenicillin and rifampicin, in conjunction with valve replacement. Rifampicin remains an alternate agent to use, when there are contraindications to traditional aminoglycoside therapy. Further data on rifampicin use in PVE are awaited.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361637PMC
http://dx.doi.org/10.1099/jmmcr.0.005085DOI Listing

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