Combined Antimicrobial Therapy for Infective Endocarditis

Despite the availability of potent antimicrobials and more aggressive and safer surgical procedures, the management of infective endocarditis remains difficult. The present chapter focuses on the in vitro, in vivo, and clinical evidence regarding the use of combination antibiotic therapy for the more common pathogens causing infective endocarditis, namely S. aureus, streptococci, and enterococci. We aim to discuss the molecular and biological rationale for combination therapies, as well as the potential pitfalls and toxicities of different approaches that encompass the use of multiple agents. We present a comprehensive review on the use of combined antimicrobial therapy in order to provide safe and effective management of difficult to treat Gram-positive infections in the setting of infective endocarditis.