Contents
Treating Native Valve Endocarditis: A Guide to Antibiotic Therapy
Published: Jun 12, 2024
Proper antibiotic treatment is crucial for curing native valve endocarditis and preventing complications. The choice and duration of antibiotics depends on the specific infecting organism.
General Treatment Principles
Treatment for native valve endocarditis requires bactericidal (bacteria-killing) antibiotics given intravenously for 2-6 weeks. Therapy is tailored based on blood culture results and antibiotic susceptibility testing. Patients need close monitoring for treatment response and complications.
Treatment for Specific Pathogens
For Staphylococcus aureus, treatment depends on methicillin susceptibility. MSSA is treated with nafcillin/oxacillin or cefazolin. MRSA requires vancomycin or daptomycin. Streptococcal endocarditis is treated with penicillin or ceftriaxone. Enterococcal endocarditis often needs combination therapy.
Duration of Therapy
Most cases of native valve endocarditis require 4-6 weeks of intravenous antibiotics. Shorter courses may be possible for right-sided endocarditis or certain streptococcal infections. The exact duration depends on the organism, valve involved, and clinical response.
Frequently Asked Questions
IV antibiotics are standard, but oral step-down may be possible in select cases.
Typically every 24-48 hours until bloodstream infection clears.
Alternative antibiotics or desensitization may be used.
Not always, but it's often used for enterococcal endocarditis.
The Bottom Line
Successful treatment of native valve endocarditis requires the right antibiotics given for an adequate duration.
References
- Baddour LM, et al. Circulation. 2015;132(15):1435-1486.
- Holland TL, et al. N Engl J Med. 2016;375(23):2261-2268.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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