Staphylococcus aureus bacteremia: A critical review of its treatment and association with infective endocarditis

Bacterial endocarditis remains a serious complication of Staphylococcus aureus (coagulase positive) bacteremia. However, it occurs significantly less frequently in those who become bacteremic in hospital, in comparison to those whose infection is community-acquired. This difference appears related to a longer bacteremic period, prior to therapy, in those with community-acquired disease. Since a significant percentage of strains of Staphylococcus aureus are still resistent to penicillin, initial treatment should include a penicillinase resistent penicillin or cephalosporin. Those patients without endocarditis appear optimally treated with two to three weeks of appropriate antibiotic therapy.