Discussion
Which of the following is the most effective drug therapy for the infections caused by Enterococcus faecalis?
Answer: B
Correct answer: Aminoglycoside with penicillin
Enterococci are only inhibited by penicillin, not killed, and aminoglycosides alone cannot cross the cell wall in sufficient quantity. Given together the penicillin damages the wall enough for the aminoglycoside to enter, and the combination is bactericidal - a genuine synergy, and the reason endocarditis is treated with two drugs rather than one. Cephalosporins are inactive against enterococci altogether.
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