Once-daily aminoglycoside in the treatment of Enterococcus faecalis endocarditis: case report and review.

Once-daily administration of aminoglycosides (ODA) is effective and safe for many indications. By optimizing pharmacodynamic principles, it enhances bactericidal activity and minimizes toxicity. Its use for the treatment of enterococcal infection is controversial, however, and results of in vitro studies and animal models of endocarditis are conflicting. To date, no case reports or clinical trials have examined its utility in human enterococcal endocarditis. A patient with right-sided endocarditis caused by Enterococcus faecalis was managed by once-daily gentamicin. Clinical and bacteriologic cures of this patient raise questions as to whether enterococcal endocarditis should be regarded as contraindication to ODA. The clinical utility of ODA in this disease deserves further investigation.

An advanced practice model: inpatient collaborative practices.

Advanced practice nurses play a key role in optimal patient care. In primary care, their functions include history taking, physical examination, development of a plan of care, instruction and counseling, use of laboratory data, diagnosis of routine illness, prescription of medications or other therapies as allowed by state laws, coordination of services, and referral when necessary. These nursing services may be provided independently or in collaboration with physician providers. Nurse-physician collaborative practices generally occur in the ambulatory care setting. The purpose of this article is to illustrate inpatient collaborative practices with CNSs and staff physicians in an urban, medical-center hospital.