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Chauhan S, D'Cruz S, Sachdev A, Singh R
Correspondence: Dr Sandeep Chauhan, email@example.com
Right-sided endocarditis caused by Staphylococcus aureus in parenteral drug abusers is potentially life-threatening, more so in the presence of pulmonary embolisation, and a course of parental antibiotics is required for at least four weeks. A combination of intravenous cloxacillin and aminoglycosides has proven efficacious for more than 90 percent of the patients. Intravenous vancomycin can also be used in cases of penicillin allergy or methicillin-resistant staphylococci. Intravenous teicoplanin, a glycopeptide with a similar antimicrobial profile to vancomycin, has been used with a somewhat lesser degree of success in these cases and is not recommended as first line therapy. We describe a 37-year-old man, a parenteral drug user, who had right-sided endocarditis, where in the absence of other alternatives, teicoplanin had to be administered intramuscularly and not intravenously.
Keywords: bacterial endocarditis, endocarditis, intramuscular teicoplanin, intravenous drug user, staphylococcal infection, Staphylococcus aureus, teicoplanin
Singapore Med J 2007; 48(9): e248–e249