IE management

Question 1

what are the 4 goals of IE therapy?

Answer 1

1- prompt diagnosis
2- determine if you need prosthetic pieces or nah
3- determine if you need to do surgery or nah
4- prevention and follow up

Question 2

what is main component and characteristic of empirical therapy?

Answer 2

should cover all possible infections, strept, staph, entercocci
usually its vancomycin

Question 3

staph IE happens in which group of people?

Answer 3

drug abusers

Question 4

do we always give prophylaxis?

Answer 4

no cuz it doesnt make a difference and it might cause adverse effects

Question 5

in which cases we give prophylaxis?

Answer 5

1- patients with prosthetic heart pieces

2- patients with previous IE

3-patients with congenital cyanosis

Question 6

at what type of operations you need

Answer 6

surgeries that disturb the oral mucosa and gingival peripheral region

surgeries done in infected fields

Question 7

how do you administer medications in empirical therapy and treatment?

Answer 7

IV only

Question 8

how do you administer medications in prophylaxis ?

Answer 8

IV, IM, Orally

Question 9

whats the prophylaxis regiment for non allergic people

Answer 9

Amoxcillin orally

Ampicillin iv/im

Ceftriaxone/Cefazolin IV/IM

Question 10

what is the prophylaxis regiment for allergic people

Answer 10

cephalexin = orally

azithromycin/clarithromycin = orally –> macrolids

Deoxyclycin = orally –> tetracyclin

ceftriaxone/cefazolin —> IV/IM

Question 11

what are the 3 main characteristics of treatment?

Answer 11

Bacterocidal

Prolonged

Parentally

Question 12

What is late prosthetic valves and early prosthetic valves?

Answer 12

Late prosthetic valves are older than one year and they are treated like native vavles

Early prosthetic valves are &laquo_space;1 year

Question 13

what is the regiment for community acquired IE of Native valve or Late prosthetic valves empiric therapy

Answer 13

• Amplicillin IV
• Ceftrioxone IV OR flucolaxillin IF ITS STAPH IV

-Gentamicin IV

Question 14

What is the regiment for Hospital acquired IE + early prosthetic valves empiric therapy

Answer 14

• Vancomycin / daptomycin IV
• Rifapmin iv
• Gentamicin IV

Question 15

what is the regiment for allergic people? empiric therapy

Answer 15

-Vancomycin / daptomycin IV

• Cefazolin IV
• Gentamicin IV

Question 16

what drug you add for prosthetic valves?

Answer 16

Rifapmin

Question 17

what are the adverse effects of gentamicin? and how long you can give it for

Answer 17

nephrotoxicity and ototoxicity

2 weeks

Question 18

what is the advantage of using Aminoglycosides and Cell wall inhibitors?

Answer 18

cell wall inhibitors make the walls more permeable and allows aminoglycosides in

Question 19

what is the best combination to treat IE due to E. faecalis

Answer 19

ampicillin and ceftriaxone

Question 20

whats the difference in treatment between Native valve Endo and Prosthetic valve Endo

Answer 20

The native valve treatment lasts for 4 weeks

Prosthetic valve lasts for 6 weeks and if its early prosthetic valve add rifapmin

Question 21

What is the treatment regimens for strept IE?

Answer 21

• Penicillin G
• Amoxcillin
• Ceftriaxone

FOR 4 weeks for Native Valve TO 6 WEEKS FOR PROSTHETIC VALVES

if you want to finish in 2 weeks, ADD GENTAMICIN

IF PENICLLIN ALLERGY give Vancomycin/daptomycin

Add rifapmin if early prosthetic valve

Question 22

whats the regiment for relatively resistance STREPT IE?

Answer 22

same as normal js increase the dose and ADD GENTAMICIN for 2 weeks.

Question 23

whats the treatment regiment for STAPH IE?

Answer 23

• Flucloxacillin cuz its staph IV
• Cefazoline IV

IF early prosthetic valve ADD RIFAPMIN AND GENTAMICIN

Question 24

what drug you give for MRSA?

Answer 24

vancomycin