+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6)
+--- Thread: Endocarditis Treatment - oncogene (/showthread.php?tid=430589)
Pages:
1
2
Endocarditis Treatment - oncogene - ArchivalUser - 07-22-2009
What is the endocarditis treatment for these patients
Prosthetic valve -------
S/p cardiac surgery-----
Staph aureus positive-----
0 - ArchivalUser - 07-22-2009
Prosthetic valve: vanco + genta + ceftriaxone
staph aureus positive: naficillin + genta (if IV drug abuser: vanco + genta)
s/p cardiac surgery: ??
0 - ArchivalUser - 07-22-2009
s/p cardiac surgery::: vancomycin + rifampin + gentamicin.
Harry what is your source for prosthetic valve treatment? Was looking at PR notes and they say the same for s/p cardiac surgery. Does your source give ceftriaxone as an alternative? thanks I a look forward to your reply
0 - ArchivalUser - 07-22-2009
my source for answer: UW-CCS explanation of IE.
Answer given is:
IV drug abuser: vanco + genta
blood culture neg prosthetic valve endocarditis: vanco + genta+ ceftriaxone
blood clture neg native valve endocarditid: ceftriaxone + genta
0 - ArchivalUser - 07-22-2009
ok thank you.
Should prophylaxis be given to patient with PDA, VSD, ASD? Some places say yes some say no. what is correct?
0 - ArchivalUser - 07-22-2009
Very imp qs oncogene
in 2007 there was change in prophylaxis recommendation for IE:
No prophylaxis required for:
- HOCM
- MVP with or without murmur
- any valvular lesion
- bicuspid aortic valve
- any GI or GU procedure
0 - ArchivalUser - 07-22-2009
Harry 206,
so this drug combo is for treatment and not for prophylaxis right ?
0 - ArchivalUser - 07-22-2009
yes this is for prophylaxis
Tt is based on culture result.
0 - ArchivalUser - 07-22-2009
but then doesnt prophylaxis differ based on what procedures are going to be done e., dental versus GI/GU ?
0 - ArchivalUser - 07-22-2009
Prophylaxis for dental procedures for example include amoxcillin PO or if unable to take oral ampi or cefazolin/ ceftriaxone IM/ IV.
My source is : http://circ.ahajournals.org/cgi/content/full/116/15/1736
I am confused about this issue based on what Harry206 said... Anyone please, can they explain in detail ?