infective_endocarditis_flashcards
What is the estimated annual incidence of infective endocarditis (IE) in children?
Approximately 0.43 cases per 100,000 per year.
What are common risk factors for IE in children?
Pre-existing heart disease or an indwelling central venous catheter.
What is recommended for patients at increased risk of developing IE?
Antibiotic prophylaxis.
What is the management approach for IE?
MDT approach involving cardiologists, cardiac surgeons, infectious disease specialists, and microbiologists.
How many blood cultures are performed in patients with suspected IE?
A minimum of three blood cultures obtained over a time period of up to 48 hours.
What should be done in critically ill children with suspected IE?
Obtain three separate cultures as quickly as possible (within <1 hour) and start empirical antibiotics promptly.
What is the protocol for blood cultures and antibiotics in children who are not acutely ill with suspected IE?
Antibiotics can be withheld for at least 48 hours while the cultures are collected.
What is the initial empirical antibiotic therapy for native valve IE?
Beta-lactam +/- low-dose gentamicin, low-dose gentamicin PLUS vancomycin (if penicillin allergic or severe sepsis), vancomycin PLUS meropenem (if severe sepsis with risk factors for Gram-ve infection).
What is the initial empirical antibiotic therapy for prosthetic valve IE?
Vancomycin PLUS rifampicin PLUS low-dose gentamicin.
What should be done when blood culture results return in IE management?
Start targeted antibiotics according to the European Society of Cardiology guidelines.
When is surgery indicated in IE management?
For removal of infected prosthetic material.
