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During this period, patients are often treated empirically for the more common bacterial causes of IE, which can result in exposure to potentially toxic therapy that could be avoided with earlier pathogen identification.

Despite the emergence of resistance to penicillins and the development of other classes of anti-infective agents, the penicillins remain one of the most important anti-infective classes of drugs well into the nineties.

Early surgery is indicated in patients with symptoms or signs of heart failure resulting from valve dehiscence, intracardiac fistula, or severe prosthetic valve dysfunction ( Class I; Level of Evidence B).

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Baseline hemodynamic measurements and post-treatment heart rates were not different among the 3 groups for all hemodynamic parameters measured ().

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Aminoglycoside-containing regimens have been a cornerstone of antimicrobial therapy for enterococcal IE and have been recommended as standard therapy in previous (1995) AHA guidelines.

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Long-term or repeated use of Ampicillin may cause a second infection.

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In contrast to other α-hemolytic streptococcal species, the S anginosus group tends to form abscesses and to cause hematogenously disseminated infection (eg, myocardial and visceral abscesses, septic arthritis, and vertebral osteomyelitis).

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