What is the primary use of Gentamicin in the context of infective endocarditis?

Gentamicin is primarily used in the context of infective endocarditis for synergy with other antibiotics, especially in the treatment of certain types of bacterial infections such as those caused by Enterococcus or Staphylococcus. In these cases, Gentamicin is not used as a standalone treatment; rather, it is combined with a beta-lactam antibiotic (like penicillin or ampicillin) to enhance the overall bactericidal effect. This synergistic action is particularly important because the bacteria responsible for infective endocarditis can be difficult to eradicate. The combined effect of the aminoglycoside (Gentamicin) and the beta-lactam leads to improved outcomes and is a key strategy in managing these infections effectively.

When considering broad-spectrum coverage, this is typically not the sole indication for using Gentamicin in endocarditis, as there are other antibiotics that can provide a wider range of activity. Also, using Gentamicin as a single agent would not be effective for treating infective endocarditis, as monotherapy does not achieve adequate efficacy. Lastly, while there may be scenarios where prophylaxis is warranted, Gentamicin is not the first choice for prophylactic measures among the antibiotics that are used before dental or surgical procedures