Infective endocarditis 2 Flashcards
Antimicrobial prophylaxis is used as an attempt to prevent infective endocarditis for patients who are at?
the highest risk however, Only a small number of cases of infective endocarditis might be prevented with antibiotic prophylaxis for dental procedures, even if 100% effective
For those with high-risk underlying cardiac conditions, prophylaxis is recommended for all dental procedures
Types of dental procedures would require antimicrobial prophylaxis?
Any that require perforation of the oral mucosa or manipulation of the periapical region of the teeth of gingival tissue
such as tooth extractions or drainage of a dental abscess; and routine dental cleaning.
Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk
what are considered Highest Risk Cardiac Conditions?
Presence of a prosthetic heart valve Prior diagnosis of infective endocarditis Cardiac transplantation with subsequent valvulopathy (or Valve regurgitation due to a structurally abnormal valve in a transplanted heart )
Congenital heart disease
Prophylaxis is not recommended based solely _________ of acquisition of infective endocarditis
on an increased lifetime risk
also not recommended in patients with common valvular lesions including bicuspid aortic valve, acquired aortic or mitral valve disease (including mitral valve prolapse with regurgitation), and hypertrophic cardiomyopathy
Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo which type of procedures?
genitourinary or GI tract procedures
routine anesthetic injections though noninfected tissue
taking dental radiographs,
placement of removable prosthodontic appliances
placement or adjustment of orthodontic appliances
placement of orthodontic brackets
shedding of deciduous teeth
and bleeding from trauma to the lips or oral mucosa
all do not require?
prophylaxis
which antibiotic used to treat IE should you avoid use if possible in patients <18 years of age?
Ciprofloxacin
Red man syndrome may occur with which antibiotic used to treat IE?
Vancomycin
HACEK Microorganisms treatment options
Ceftriaxone, Ampicillin (ampicillin- sulbactam), or Ciprofloxcin
all are 4 week long duration
Culture-Negative Endocarditis, Native Valve
treatment options
Vancomcyin plus cefepime
Vancomycin plus ampicillin-sulbactam
4 to 6 week long duration
Culture-Negative Endocarditis, Early (<1 Year) Prosthetic Valve treatment
Vancomycin plus cefepime plus rifampin plus gentamicin
6 weeks
Culture-Negative Endocarditis, Late (>1 Year) Prosthetic Valve treatment options
Vancomycin plus ceftriaxone
6 weeks
Suspected Bartonella, Culture-Negative
treatment options
Ceftriaxone plus gentamicin with or without doxycycline
Culture-Positive Bartonella treatment options
Doxycycline plus gentamicin
Rifampin is recommended as an alternative in patient who cannot be given which drug?
gentamicin
