Bacterial endocarditis over prosthetic valves treated with trimethoprim-sulphamethoxazole combination.

During the past few years a number of reports have indicated the therapeutic effectiveness of the new synthetic chemotherapeutic agent trimethoprim (2,4-diamino-5-(3,4,5-trimethoxybenzyl) pyrimidine) used in combination with sulphamethoxazole in a wide range of bacterial infections (Noall, Sewards, and Waterworth, i962; Schneider et al., i965; Akinkugbe et al., I968; Hughes, I969). Staphylococcus aureus shows a consistently high sensitivity to trimethoprim in vitro. This combination has also been effective in a case of endocarditis due to Esch. coli (Fowle and Zorab, I970). This report describes the second case of bacterial endocarditis successfully treated with this combination. However, it is the first published report of the successful use of this chemotherapeutic agent in endocarditis involving prosthetic cardiac valves.