We suggested that netilmicin might be preferable to gentamicin in endocarditis caused by faecal streptococci to reduce unwanted effects from prolonged treatment. “Faecal streptococci” comprise two species, Strep faecalis, and the rare Strep faecium which is innately resistant to netilmicin as we noted in 1982. Both species are increasingly showing high-level gentamicin resistance in America. Laboratory tests are essential to determine optimal treatment, and netilmicin should not be universally substituted for gentamicin in endocarditis caused by unspeciated “faecal streptococci”.
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