What is the treatment regimen for acute bacterial endocarditis caused by Staphylococcus aureus?

The recommended treatment for acute bacterial endocarditis caused by Staphylococcus aureus is the combination of nafcillin and gentamicin. Nafcillin is a penicillinase-resistant penicillin that is effective against Staphylococcus aureus, especially in cases of methicillin-susceptible strains. Gentamicin is an aminoglycoside that provides synergy when used with nafcillin, enhancing bacterial eradication, especially in the setting of valvular infection.

In patients with suspected or confirmed acute bacterial endocarditis, the use of this combination helps to ensure effective treatment while addressing the virulent nature of Staphylococcus aureus, which is known for its rapid progression and potential for complications. This regimen is backed by clinical guidelines and studies emphasizing its efficacy in managing acute endocarditis and minimizing adverse outcomes.

Other regimens may not provide the same level of effectiveness against Staphylococcus aureus, particularly in cases of methicillin-sensitive strains. While alternative options may be appropriate in different contexts, nafcillin plus gentamicin represents the cornerstone of therapy for this specific infection.