Endocarditis Flashcards
Most common causative organisms:
Staph aureus
Strep viridans
Enterococcus
Staph epidermidis
Endocarditis not long after valve replacement surgery:
Staph epidermidis or Staph aureus
Endocarditis in IV drug user:
Staph aureus
- right sided
- tricuspid valve
- often presents as Staph aureus pneumonia
Dukes major criteria:
- positive blood culture
- endocardium involved (+ve echocardiogram or new valvular regurgitation)
Dukes minor criteria:
- predisposition
- fever >38
- vascular/immunological signs
- positive blood culture that doesn’t meet major criteria
- positive endocardium that doesn’t meet major criteria
How do you diagnose use Dukes criteria?
- 2 major
- 1 major and 3 minor
- all five minor
How are antibiotics given for endocarditis?
high dose, frequent, IV (not oral because infection at a deep, critical site)
Antibiotics for native valve endocarditis:
Amoxicillin and gentamicin
vancomycin in penicillin allergic
Antibiotics for prosthetic valve endocarditis:
IV vancomycin and gentamicin, oral rifampicin
Antibiotics for IV drug user with endocarditis:
Flucloxacillin (targeting staph aureus)
Antibiotics for Staph aureus (not MRSA):
Flucloxacillin IV
Antibiotics for MRSA or Staph aureus but allergic to penicillin:
Vancomycin and rifampicin
Antibiotics for Strep viridans:
Benzylpenicillin and gentamicin
Antibiotics for Enterococcus:
Amoxicillin/vancomycin and gentamicin
Antibiotics for Staph epidermidis:
Vancomycin and gentamicin IV and rifampicin PO
