Ie

Question 1

What are examples of broad-spectrum antibiotics?

Answer 1

Aminopenicillins: amoxicillin (+/- clavulanate → Augmentin), ampicillin.

Broader spectrum than penicillin; coverage includes some gram positive aerobes and gram negative bacilli.

Question 2

What are other examples of broad-spectrum antibiotics?

Answer 2

Carbapenems: imipenem, meropenem.

Resistant to beta-lactamase in bacteria; coverage includes gram positive cocci, gram negative bacilli, and anaerobes.

Question 3

What is the most common complication of infective endocarditis (IE)?

Answer 3

Heart failure (50% of patients).

Question 4

What are some systemic embolization sites in IE?

Answer 4

Left-sided: brain and spleen; Right-sided: lungs.

Question 5

What are neurological complications of IE?

Answer 5

Stroke, mycotic aneurysm, cerebral abscess, meningitis.

Question 6

What are potential complications of IE?

Answer 6

Persistent infection or perivalvular extension.

Question 7

How should you counsel a patient regarding future dental procedures if they had previous IE?

Answer 7

Patients with previous IE are considered high risk for recurrence; antibiotic prophylaxis is required for invasive dental procedures involving manipulation of gingival or oral mucosa.

Regime: oral or IV amoxicillin 2g.

Question 8

What are the indications for surgery in IE?

Answer 8

Severe valvular regurgitation, heart failure, uncontrolled sepsis/paravalvular extension, fungal or multiresistant IE, large vegetations (>10 mm), recurrent systemic embolization.