Infectious Endocarditis (Nicasio)

Question 1

VSPS + Natural Valve

Answer 1

Penn G --> 4wk
or
Penn G + Gentamycin --> 4/2wk
or
Vancomycin --> 2wk

Question 2

VSPS + Artificial Valve

Answer 2

Penn G + Gentamycin –> 6/2wk
or
Vancomycin –> 4wk

Question 3

VSPR + Natural Valve

Answer 3

Penn G + Gentamycin –> 4/2wk
or
Vancomycin –> 4wk

Question 4

VSPR + Artificial Valve

Answer 4

Penn G + Gentamycin –> 6/6wk
or
Vancomycin –> 6wk

Question 5

E. Faecium (Natural/Prosthetic)

Penn Susceptible

Answer 5

Ampicillin + Sulbactam –> 6wk
or
Vancomycin + Gentamycin –> 6wk

Question 6

E. Faecium (Natural/Prosthetic)

Penn Resistant

Answer 6

Ampicillin + Sulbactam + Gentamycin –> 6wk
or
Vancomycin + Gentamycin –> 6wk

Question 7

E. Faecium (Natural/Prosthetic)
Vanco Resistant (MIC > 1.5mg/L)

Answer 7

Daptomycin + Gentamycin –> 6wk
or
Quinupristim/Dalfopristim + Gentamycin –> 6wk

Question 8

MSSA/MSSE (Natural)

Answer 8

Nafcillin + Gentamycin –> 6wk/3-5d
or
Vancomycin –> 6wk

Question 9

MRSA/MRSE (Natural)

Answer 9

Vancomycin –> 6wk
or
Daptomycin –> 6wk

Question 10

MSSA/MSSE (Prosthetic)

Answer 10

Triple Therapy:

Nafcillin + Rifampin + Gentamycin (6wk/6wk/2wk)

Question 11

MRSA/MRSE (Prosthetic)

Answer 11

Triple Therapy:

Vancomycin + Rifampin + Gentamycin (6wk/6wk/2wk)

Question 12

When to use Ceftaroline?

Answer 12

-Salvage therapy for Vanco non-susceptible (MIC > 1mg/L) and dapto intolerant Staph aureus

Question 13

Therapy Evaluation: Sx/Symptoms

Answer 13

Fever subside within 7d

Echocardiography should be performed

Question 14

Therapy Evaluation: BCx

Answer 14

Blood Cultures
Negative after 1wk
Check again 1-2x 8wk post therapy

Question 15

Endocarditis: High Risk Groups (4)

Answer 15

Prosthetic Heart Valves
Previous infective Endocarditis
Cardiac Transplant
Congenital Hearth Disease