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The antibiotics were subsequently given by the oral route (co-trimoxazole at the same dosage and ciprofloxacin at 250 mg tds) and, after 2 weeks, the dosages were reduced (co-trimoxazole 480 mg bd and ciprofloxacin 250 mg bd). The patient completed a 4 week course of this regimen, during which time she remained afebrile. She was discharged and, at a 6 month follow-up assessment, was well and exhibited no signs of relapse. This case demonstrates that co-trimoxazole in combination with ciprofloxacin may be effective therapy in patients with IE caused by high-level gentamicin-resistant enterococci.

Teicoplanin-resistant coagulase-negative staphylococcal bacteraemia in patients with haematological malignancies: a problem of increasing importance