Efficacy of the combination ampicillin plus ceftriaxone in the treatment of a case of enterococcal endocarditis due to Enterococcus faecalis highly resistant to gentamicin: Efficacy of the "ex vivo" synergism method

The case of a patient with highly gentamicin-resistant Enterococcus faecalis endocarditis treated with an ampicillin + ceftriaxone combination is described. We have designed a method to evaluate synergism between the antibacterial activity of patient's serum taken during a given antibiotic regimen (ampicillin) to which another antibiotic (ceftriaxone) is added in vitro. In this patient the two-drug combination was able to stop the bacteremia and prevent the infection of the prosthetic valve.