Emerging treatments
Multidrug resistance
Multidrug resistance is an increasing problem and has a significant impact on the outcomes of patients with IE. More research is necessary to define appropriate treatments for resistant Staphylococcus aureus infections, as well as Streptococcus pneumoniae and vancomycin-resistant strains of Enterococcus faecium.
Dalbavancin
Dalbavancin is a long-acting lipoglycopeptide antibiotic that demonstrates strong activity against multidrug resistant gram-positive bacteria. Although it is currently only approved for acute bacterial skin and skin structure infections, it has shown promise in the treatment of IE.[127][128]
Tigecycline
Potential therapy for multidrug-resistant enterococci; however, there are minimal published data on its clinical use.[6]
AngioVac®
AngioVac® is a percutaneous vacuum based device most commonly used to aspirate thrombi in the right heart chambers and the pulmonary vasculature. This device has been used for debulking of right-sided IE. More study is needed to establish efficacy and safety of this device in IE.[129]
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