Endocarditis Treatment - oncogene

[ArchivalUser]

What is the endocarditis treatment for these patients

Prosthetic valve -------

S/p cardiac surgery-----

Staph aureus positive-----

[ArchivalUser]

Prosthetic valve: vanco + genta + ceftriaxone

staph aureus positive: naficillin + genta (if IV drug abuser: vanco + genta)

s/p cardiac surgery: ??

[ArchivalUser]

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

[ArchivalUser]

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

[ArchivalUser]

ok thank you.

Should prophylaxis be given to patient with PDA, VSD, ASD? Some places say yes some say no. what is correct?

[ArchivalUser]

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

[ArchivalUser]

Harry 206,

so this drug combo is for treatment and not for prophylaxis right ?

[ArchivalUser]

yes this is for prophylaxis

Tt is based on culture result.

[ArchivalUser]

but then doesnt prophylaxis differ based on what procedures are going to be done e., dental versus GI/GU ?

[ArchivalUser]

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/...16/15/1736

I am confused about this issue based on what Harry206 said... Anyone please, can they explain in detail ?