Old antimicrobials and Gram-positive cocci through the example of infective endocarditis and bone and joint infections

- Infective endocarditis and bone and joint infections caused by Gram-positive cocci are serious infections.
- Management of these infections requires effective antimicrobials with high bioavailability in affected tissues.
- Use of higher antimicrobial dosing may result in increased toxicity.
- Use of new promising antimicrobials could still bring about new toxicity and resistance.
- Another approach may be the 'comeback' of old antimicrobials in the treatment of these infections.

The management of some serious infections such as infective endocarditis (IE) and bone and joint infections (BJIs) caused by Gram-positive cocci (GPC) is complex and requires great responsiveness and effective antimicrobials with high bioavailability in heart valves or bone tissues. Treatment of these infections requires the use of a higher dosage that may result in increased toxicity or the use of new promising antimicrobials to control the infection. However, use of these new antimicrobials could still bring about new toxicity and resistance. Another approach may be the 'comeback' of old antimicrobials, which is evaluated in this review in the treatment of IE and BJIs caused by GPC.