Eng R H, Wolff M, Smith S M
Arch Intern Med. 1982 Oct;142(10):1958-9.
Use of oral erythromycin to prevent bacterial endocarditis has been accepted in the treatment of penicillin-allergic patients who required oral or sinusal surgery. A case of Streptococcus sanguis endocarditis, however, developed in a patient following intravenous erythromycin administration during surgery on the maxillary sinus. The organism isolated proved resistant to erythromycin. This isolation of an erythromycin-resistant organism, together with previous reports of the drug's failure in preventing endocarditis in animal models, and recognition of the bacteriostatic action of erythromycin, argue for caution in our current practice of using erythromycin as a single drug therapy to prevent endocarditis in the patient who is allergic to penicillin.
对于需要进行口腔或鼻窦手术的青霉素过敏患者，使用口服红霉素预防细菌性心内膜炎已被认可。然而，一名患者在进行上颌窦手术期间静脉注射红霉素后发生了血链球菌心内膜炎。分离出的病原体对红霉素耐药。这种对红霉素耐药的病原体的分离，加上之前关于该药物在动物模型中预防心内膜炎失败的报道，以及对红霉素抑菌作用的认识，提示我们在目前将红霉素作为单一药物疗法用于预防青霉素过敏患者的心内膜炎的实践中应谨慎行事。
