Susceptibility of α-haemolytic streptococci causing endocarditis to benzylpenicillin and ten cephalosporins

A clinical case of streptococcal endocarditis in which the isolate proved susceptible to third- but not first-generation cephalosporins prompted us to examine the susceptibility of 44 alpha-haemolytic streptococci from cases of endocarditis to ten cephalosporins and benzylpenicillin. Twenty per cent of strains were resistant to penicillin, and 20% were tolerant. Cefazolin, cefuroxime and cefpirome were the most active first-, second- and third-generation cephalosporins tested. Other first-generation cephalosporins tested compared poorly to cefazolin. Cefotaxime and cefpirome were moderately active against some penicillin-resistant strains. Penicillin tolerance was common in Streptococcus gordonii, but a correlation between tolerance and dextran production could not be confirmed.