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Pharm 3 Shea > Endocarditis 2 (tables)- MJ > Flashcards

Endocarditis 2 (tables)- MJ Flashcards

1
Q

Native Valve Endocarditis:

What are the 5 possible tx options for highly penicillin susceptible viridans group streptococci

A

Aqueous crystalline Penicillin G sodium x4wks

OR

Ceftriaxone x4wks

OR

Aqueous crystalline penicillin G sodium + gentamicin x2wks

OR

Ceftriaxone + gentamicin x2wks

OR

Vancomycin x4wks

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2
Q

Native Valve Endocarditis:

What are the 3 possible tx options for Viridans Group Streptococci and S. Gallolyticus relatively resistant to penicillin

A

Aqueous crytalline Penicillin G sodium + gentamicin

OR

Ceftriaxone + gentamicin

OR

Vancomycin x4wks

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3
Q

Native Valve Endocarditis:

What are the 4 possible tx options for Oxacillin-susceptible staphylococci

A

Nafcillin or oxacillin x6wks

OR

Cefazolin x6wks

OR

Vancomycin x6wks

OR

Daptomycin x6wks

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4
Q

Native Valve Endocarditis:

What are the 4 possible tx options for Oxacillin-resistant staphylococci

A

Vancomycin x6wks

OR

Daptomycin x6wks

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5
Q

Prosthetic valve endocarditis (PVE):

What are the 3 possible tx options for highly penicillin-susceptible Viridans group Streptococci

A

Aqueous crystalline Penicillin G sodium +/- gentamicin

OR

Ceftriaxone +/- gentamicin

OR

Vancomycin x6wks (only if cant tolerate PCN or ceftriaxone)

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6
Q

Prosthetic valve endocarditis (PVE):

What are the 3 possible tx options for relatively resistant or fully resistant Viridans group Streptococci

A

Aqueous crystalline Penicillin G sodium + gentamicin x6wks

OR

Ceftriaxone + gentamicin x6wks

OR

Vancomycin x6wks (only if unable to tolerate PCN or ceftriaxone)

(pretty much same as highly PCN-susceptible Strep viridans)

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7
Q

Prosthetic valve endocarditis (PVE):

What are the 2 possible tx options for oxacillin-susceptible staphylococci?

A

Nafcillin or oxacillin + Rifampin + gentamicin

OR

Vancomycin + Rifampin + gentamicin (for pts w/ anaphylactoid-type hypersensitivity to PCN/cephalosporins)

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8
Q

Prosthetic valve endocarditis (PVE):

What is the tx for oxacillin-resistant staphylococci?

A

Vancomycin + Rifampin + gentamicin

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9
Q

Combination therapy with __________has not demonstrated superior cure rates compared with monotherapy with a penicillin or cephalosporin and should be avoided in patients with CrCl <30 mL/min (<0.50 mL/s)

A

gentamicin

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10
Q

How do you tx NVE or PVE caused by enterococci that is Ampicillin-, penicillin-, and vancomycin susceptible

A

Ampicillin + gentamicin x4-6wks

OR

Aqueous crystalline penicillin G + gentamicin x4-6wks

OR

Ampicillin + ceftriaxone x6wks (if CrCl <50)

OR

Vancomycin + gentamicin x6wks (if unable to tol PCN or ampicillin)

**if gentamicin-resistant strain- use streptomycin in place of gentamicin**

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11
Q

How do you tx NVE or PVE caused by enterococci that is penicillin-resistant

A

Ampicillin-sulbactam + gentamicin x6wks

OR

Vancomycin + gentamicin x 6wks

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12
Q

How do you tx NVE or PVE caused by enterococous Faecium strains resistant to PCN, aminoglycosides and vancomycin? (2 meds)

A

Linezolid >6wks

OR

Daptomycin >6wks

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13
Q

What are the 3 tx options used to tx Endocarditis caused by HACEK microorganisms

A

Ceftriaxone x4wks

OR

Ampicillin or Ampicillin-sulbactam x4wks

OR

Ciprofloxacin x4wks

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14
Q

How should culture-negative native valve endocarditis be treated if it is acute (days)?

A

Vancomycin + cefepime x4-6wks

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15
Q

How should culture-negative native valve endocarditis be treated if it is subacute (weeks)?

A

Vancomycin + ampicillin-sulbactam x4-6wks

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16
Q

How do you tx culture negative endocarditis, Early (<1year) prosthetic valve

A

Vancomycin + cefepime + rifampin + gentamicin x6wks

17
Q

How do you tx culture negative endocarditis, Late (> 1year) prosthetic valve

A

Vancomycin + ceftriaxone x6wks

18
Q

How is endocarditis treated if culture is negative but Bartonella is suspected

A

Ceftriaxone + gentamicin +/- doxycycline

19
Q

How is endocarditis treated if caused by culture-positive Bartonella

A

Doxycycline + gentamicin

(replace w/ Rifampin if cant take gentamicin)

20
Q

What prophylactic tx should be given to pts if they are unable to take oral meds (2)

A

IM or IV ampicillin

OR

IM or IV cefazolin or ceftriaxone

21
Q

What do you give for endocarditis prophylaxis if the pt is allergic to PCN and is able to take oral meds

A

oral cephalexin

OR

oral clindamycin

OR

oral azithromycin or clarithromycin

22
Q

What do you give for endocarditis prophylaxis if the pt is allergic to PCN and is UNABLE to take oral meds

A

IV or IM clindamycin

OR

IM or IV Cefazolin or ceftriaxone

OR

IV Vancomycin

Pharm 3 Shea (17 decks)

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