Infective Endocarditis empiric therapies

Question 1

Native valve; highly susceptible strep

name AND dose AND DoT for all

Answer 1

PCN-G 18M units/24h +/- 2 week course of gentimicin

DoT: 2-4 weeks

Question 2

Prosthetic valve; high susceptible strep

Answer 2

PCN-G 24M units/24h + mandatory 2 week course of gentimicin

DoT: 6 weeks

Question 3

Native valve; relatively resistant strep

Answer 3

PCN-G 24M units/24h + mandatory 2 week course of gentimicin

DoT: 4 weeks

Question 4

Prosthetic valve; relatively resistant strep

Answer 4

PCN-G 24M units/24h + mandatory 6 week course of gentimicin

DoT: 6 weeks

Question 5

Native valve; highly resistant strep

Answer 5

ampicillin 12g/24h OR PCN-G 18-30M units/24h + 4-6 weeks of ceftriaxone OR gentimicin

DoT: 4-6 weeks

Question 6

Native valve; Enterococci (susceptible)

Answer 6

ampicillin 12g/24h OR PCN-G 18-30M units/24h + 4-6 weeks of ceftriaxone OR gentimicin

DoT: 4-6 weeks

Question 7

Prosthetic valve; highly resistant strep

Answer 7

ampicillin 12g/24h OR PCN-G 18-30M units/24h + 4-6 weeks of ceftriaxone OR gentimicin

DoT: 6 weeks

Question 8

Prosthetic valve; Enterococci (susceptible)

Answer 8

ampicillin 12g/24h OR PCN-G 18-30M units/24h + 4-6 weeks of ceftriaxone OR gentimicin

DoT: 6 weeks

Question 9

Enterococci (beta-lactam resistant)

Answer 9

linezolid, synercid, daptomycin

DoT: 8 weeks

Question 10

Native valve; MSSA

Answer 10

nafcillin 12g/24h OR cefazolin

DoT: 6 weeks

Question 11

Prosthetic valve; MSSA

Answer 11

nafcillin +rifampin+ gentimicin(2 weeks)

DoT: 6-8 weeks

Question 12

Native valve; MRSA

Answer 12

vancomycin OR daptomycin

DoT: 6 weeks

Question 13

Prosthetic valve; MRSA

Answer 13

vancomycin+rifampin+gentimicin (2 weeks)

DoT: 6-8 weeks

Question 14

HACEK (for both valve types)

Answer 14

ceftriaxone or unasyn

DoT: 4 weeks