Moy R J, George R H, de Giovanni J V, Silove E D
Arch Dis Child. 1986 Apr;61(4):394-9. doi: 10.1136/adc.61.4.394.
Twenty six cases of bacterial endocarditis in infancy and childhood were treated with a mortality of less than 8%. Twenty two had recognised congenital heart disease and four had previously normal hearts. Thirteen out of the 24 cases with positive blood cultures had staphylococcal infection. Appropriate antibiotics were identified by measurement of the minimum bactericidal concentration as an indicator of antibiotic sensitivity. The bactericidal activity of the patient's serum during treatment was monitored by back titration against the causative organism to assess the optimal antibiotic combination and dosage. Treatment was continued for six weeks in most cases, comprising intravenous treatment for at least the first three weeks, but then being substituted with oral treatment in some. Twenty one cases were successfully treated medically. Five developed complications requiring surgery, two of whom died.
26例婴幼儿和儿童细菌性心内膜炎患者接受了治疗，死亡率低于8%。其中22例患有先天性心脏病，4例此前心脏正常。血培养呈阳性的24例患者中，13例为葡萄球菌感染。通过测定最低杀菌浓度作为抗生素敏感性指标来确定合适的抗生素。在治疗期间，通过对致病微生物进行反滴定来监测患者血清的杀菌活性，以评估最佳抗生素组合和剂量。大多数病例持续治疗六周，至少前三周采用静脉治疗，部分病例随后改为口服治疗。21例通过药物治疗成功治愈。5例出现需要手术的并发症，其中2例死亡。
