Combination antimicrobial therapy for Staphylococcus aureus endocarditis in patients addicted to parenteral drugs and in nonaddicts: A prospective study

Ann Intern Med. 1982 Oct;97(4):496-503. doi: 10.7326/0003-4819-97-4-496.


Single (nafcillin for 6 weeks) and combined (nafcillin for 6 weeks plus gentamicin for 2 weeks) drug regimens were compared in two separate multicenter prospective randomized trials. Forty-eight parenteral drug addicts and 30 nonaddicts with clinically and bacteriologically documented Staphylococcus aureus endocarditis were studied. In the addicts, combined therapy effected a more rapid mean clinical response (defervescence and normalization of leukocyte count) and a reduced duration of bacteremia in patients with right-sided endocarditis. In the nonaddicts, combined therapy effected more rapid clearance of bacteremia, but was associated with a higher incidence of azotemia. The addition of gentamicin did not alter morbidity or mortality in either group.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Clinical Trials as Topic
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / etiology
  • Female
  • Gentamicins / administration & dosage*
  • Gentamicins / therapeutic use
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Nafcillin / administration & dosage*
  • Nafcillin / therapeutic use
  • Prospective Studies
  • Random Allocation
  • Staphylococcal Infections / drug therapy*
  • Substance-Related Disorders*


  • Gentamicins
  • Nafcillin