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Question 1

Drug treatment of PVE should last longer (at least 6 weeks) than that of native valve endocarditis (NVE) (2–6 weeks), but is otherwise similar, except for staphylococcal PVE where the regimen should include

Answer 1

rifampin whenever the strain is susceptible

Question 2

n both NVE and PVE, the duration of treatment is based on

Answer 2

the first day of effective anti- biotic therapy, not on the day of surgery

Question 3

Penicillin-susceptible oral streptococci and group D streptococci

• 4 weeks
• 2 weeks
• B lactam allergic patients

Answer 3

• Penicilina o amoxicilina o ceftriaxona
• (Penicilina o amoxicilina o ceftriaxona) + gentamicina
• Vancomicina

Question 4

Penicillin-resistant oral streptococci and
group D streptococci
- Standard
- B lactam allergic

Answer 4

• (4 sem Penicilina o amoxicilina) + 2 sem gentamicina

- vancomicina 4 sem + 2 sem gentamicina

Question 5

SAMS

• Nativa
• Protesica

Answer 5

• 4-6 semanas cloxacilina + 3-5 días gentamicina

- ≥ 6 sem cloxacilina + ≥6 sem rifampicina + 2 sem gentamicina

Question 6

SAMR (o SAMS alérgicos)

• Nativa
• Protésica

Answer 6

• 4-6 sem vancomicina + 3-5 días gentamicina

- ≥ 6 sem vancomicina + ≥6 sem rifampicina + 2 sem gentamicina

Question 7

Enterococo

• Sensible
• Resistente

Answer 7

• 4-6 sem ampicilina + 4-6 sem gentamicina

- 4-6 sem vancomicina + 4-6 sem gentamicina

Question 8

Empirico

• Nativo (o protésicas >12m)
• Protésicas

Answer 8

• (4-6 sem ampi/sulbactam o amoxicilina clav) + 4-6 sem gentamicina o 4-6 sem vanco + cipro+ genta
• 6 sem vanco + 2 sem genta + rifampicina

Question 9

Indicaciones quirúrgicas

Answer 9

• Falla cardíaca
• Uncontrolled infection
• Prevención de embolismo

Question 10

Emergency

Answer 10

Shock cardiogénico o EPA

Question 11

Uncontrolled infection

Answer 11

• Persisting infection: fever and cultures >7-10 days
• Perivalvular extension in infective endocarditis (abscess formation, pseudoaneurysms, and fistulae, enlarging vegetation)
• fungi or multiresistant bacteria

Question 12

Prevención de embolismo

Answer 12

• vegetations (.10mm) following one or more clinical or silent embolic events
• (.10 mm), and other predictors of a complicated course (HF, persistent infection despite appropriate antibiotic therapy, abscess)
• (.15 mm) isolated vegetations on the aortic or mitral valve