Infectious Diseases II: Endocarditis

Question 1

What is used to diagnose endocarditis?

Answer 1

echocardiogram

Modified duke criteria

Question 2

Most common organism that cause endocarditis [3]

Answer 2

Staph
Strept
Entercoccus

Question 3

General empiric treatment of endocarditis

Answer 3

Vancomycin
Ceftriaxone

Gentamicin (used for synergy with certain pathogens)

Question 4

General duration of treatment

Answer 4

4-6 weeks
depends on type of pathogen
which valve
artificial valves usually require longer treatments

Question 5

Which antibiotic can be used for staph prosthetic valve endocarditis?

Answer 5

Rifampin

helps break down biofilm that can form of prosthetic valve

Question 6

Preferred regimen for Streptococci endo

Answer 6

Penicillin, ampicillin, ceftriaxone +/- gent (for synergy)\

Vanco if beta-lactam allergy

Question 7

Preferred regimen for MSSA endo

Answer 7

Nafcillin or cefazolin

Vanco for beta lactam allergy

Question 8

Preferred regimen for MRSA endo

Answer 8

Vanco (+ gent for prosthetic valve)

Question 9

Preferred treatment for enterococci endo

Answer 9

Pencillin or ampicillin

Vanco + gent if beta lactam allergy

Question 10

Pts at high risk for endocarditis that should take dental prophylaxis

Answer 10

Artificial heart valve
Hx of endocarditis
Heart transplant
Certain congenital heart defects

Question 11

Preferred dental prophylaxis regimen

Answer 11

amoxicllin 2 g 30-60 mins prior to procedure

Question 12

Dental prophylaxis for PCN allergy

Answer 12

Cephalexin/cefadroxil 2 grams
Clindamycin 600 mg
Azith/clarithromycin 500 mg