infective endocarditis 2

Question 1

what are the two most common strep organisms that cause IE

Answer 1

Viridans Strep

S. Bovis

Question 2

what is the treatment for patients over 65 or with native valve IE with no resistance

Answer 2

penicillin G
or
Ceftriaxone

Question 3

what is the duration of therapy for patients over 65 or with native valve IE with no resistance

Answer 3

4 weeks

Question 4

what is the duration of therapy for patients on penicillin G or ceftriaxone plus gentamicin for native valve strep IE

Answer 4

2 weeks

Question 5

who can’t use penicillin G or ceftriaxone plus gentamicin for native valve strep IE

Answer 5

pts. with ascess or with a CrCl less than 20

Question 6

what is recommended when patients are unable to tolerate beta lactam antibiotics with a native valve IE

Answer 6

vancomycin

Question 7

what is the duration of vancomycin for treating a native valve strep IE

Answer 7

4 weeks

Question 8

what is the recommended treatment for patients with a native valve strep IE and is penicillin intermediate/ resistant and durations?

Answer 8

still can use penicillin G or ceftriaxone for 4 weeks
plus gentamicin therapy for 2 weeks
OR
4 weeks of Vancomycin

Question 9

what is recommended for PCN susceptible patients strep IE and a prosthetic valve and for what duration?

Answer 9

penicillin G or ceftriaxone for 6 weeks

with or without gentamicin for 2 weeks

Question 10

what is recommended for PCN susceptible patients strep IE and a prosthetic valve unable to tolerate beta lactam antibiotics and for what duration?

Answer 10

vancomycin for 6 weeks

Question 11

what is recommended for PCN intermediate/ resistant patients strep IE and a prosthetic valve unable to tolerate beta lactam antibiotics and for what duration?

Answer 11

vancomycin for 6 weeks

Question 12

what is recommended for PCN intermediate/ resistant patients strep IE and a prosthetic valve and for what duration?

Answer 12

penicillin G or ceftriaxone for 6 weeks
PLUS
Gentamicin for 6 weeks
(vanc monotherapy is preferred)

Question 13

what is the recommended treatment for patients with a native valve, oxacillin susceptible staph IE and duration

Answer 13

nafcillin for 6 weeks

with or without gentamicin for 3-5 days

Question 14

what is the recommended treatment for patients with a native valve, oxacillin susceptible staph IE and duration for penicillin allergic patients

Answer 14

cefazolin for 6 weeks
with or without gentamicin for 3-5 days
(vancomycin is preferred)

Question 15

what is the recommended treatment for patients with a native valve, oxacillin resistant staph IE and duration

Answer 15

vancomycin for 6 weeks

Question 16

what is the alternative treatment for patients with a native valve, oxacillin resistant staph IE and duration

Answer 16

daptomycin

Question 17

what is another name for oxacillin resistant staph strains

Answer 17

MRSA

Question 18

what is another naim for oxacillin susceptible staph

Answer 18

MSSA

Question 19

what is native valve staph IE treatment is avoided if a patient has a anaphylaxis reaction to penicillin

Answer 19

cefazolin

go with vanc

Question 20

what is the recommended treatment for patients with a prosthetic valve, oxacillin susceptible staph IE and duration

Answer 20

nafcillin or oxacillin for 6 weeks or longer
PLUS
Rifampin for 6 weeks or longer
PLUS
Gentamicin for 2 weeks

Question 21

what is the recommended treatment for patients with a prosthetic valve, oxacillin resistant staph IE and duration

Answer 21

vancomycin for 6 weeks or longer
PLUS
Rifampin for 6 weeks or longer
PLUS
Gentamicin for 2 weeks

Question 22

what is the only condition where vancomycin is used in combination with gentamicin

Answer 22

oxacillin resistant staph (MRSA) IE in a prosthetic valve