infective endocarditis 3 Flashcards
what is the recommended treatment for patients with a prosthetic valve or native valve with a intrinsic penicillin resistance enteroccocal IE, and duration
Vanc for 6 weeks
PLUS
Gent for 6 weeks
when is gentamicin mandatory
for enterococcal IE (unless resistant)
what is the recommended treatment for patients with a prosthetic valve or native valve with no penicillin resistance enteroccocal IE, and duration
ampicillin or penicillin G for 4-6 weeks
PLUS
Gentamicin for 4-6 weeks
what is the recommended treatment for patients with a prosthetic valve or native valve with no penicillin resistance enteroccocal IE, but unable to tolerate beta lactam antibiotics; and duration
Vanc for 6 weeks
PLUS
Gent for 6 weeks
what is the recommended treatment for patients with a prosthetic valve native valve with gentamicin resistance resistance enteroccocal IE, and duration
ampicillin or penicillin G for 4-6 weeks
PLUS
streptomycin for 4-6 weeks
what is the recommended treatment for patients with a prosthetic valve or native valve with gentamicin resistance resistance enteroccocal IE, but unable to tolerate beta lactam antibiotics; and duration
Vanc for 6 weeks
PLUS
streptomycin for 6 weeks
what is the recommended treatment for patients with a prosthetic valve or native valve with penicillin, aminoglycoside, and vancomycin resistance enterococcus faecium IE, and duration
linezolid for 8 weeks or longer
or
quinupristin-dalfopristin for 8 weeks or longer
what is the recommended treatment for patients with a prosthetic valve or native valve with penicillin, aminoglycoside, and vancomycin resistance enterococcus faecalis IE, and duration
imipenem/ cilastatin plus ampicillin for 8 weeks or longer
or
ceftriaxone plus ampicillin for 8 weeks or longer
what must be monitored when treating resistant enterococcus faecium with linezolid
thrombocytopenia
when does treatment duration start when treating IE
from 1st day of negative blood culture
what needs to be monitored when treating IE
renal function (especially with aminoglycosides > 1 week) vancomycin and aminoglycoside concentrations
what is the goal vancomycinn trough when treating IE
15-20
what is the goal gentamicin trough and peak when treating IE
trough= less than 1
peak = 3-5
(synergistic dosing)
what bacteria most commonly cause native aortic valve endocarditis
staph, strep, and enterococci
