Infective endocarditis prevention resident survival guide
For infective endocarditis resident survival guide click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]; Rim Halaby, M.D. [3]
Overview
Prevention of infective endocarditis can be achieved through the administration of antiobiotic prophylaxis to high risk subjects who are undergoing high risk procedures. The choice of antibiotic prophylaxis depends on whether the subject can tolerate oral intake or not, as well as on whether patient has allergy to penicillin or not.
Prevention
Shown below is an algorithm depicting the general prophylactic approaches of infective endocarditis.[1][2]
Identify high risk patients: (Class IIa, Level of evidence B)
❑ Prosthetic valves patients
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Identify high risk procedures:
❑ Respiratory tract procedures involving incision of the respiratory tract mucosa ❑ Gastrointestinal (GI) and genitourinary (GU) procedures only if GI or GU tract infection is present | |||||||||
❑ Administer prophylaxis
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Antibiotic Prophylaxis
Shown below is an algorithm depicting the prophylaxis antibiotic regimens for infective endocarditis.[2]
| Does the patient have allergy to penicillin? | |||||||||||||||||||||||||||||||
| NO | Yes | ||||||||||||||||||||||||||||||
| Does the patient tolerate oral therapy? | Does the patient tolerate oral therapy? | ||||||||||||||||||||||||||||||
| YES | NO | YES | NO | ||||||||||||||||||||||||||||
| ❑ Amoxicillin 2 g | ❑ Cefalexin 2 g OR ❑ Clindamycin 600 mg OR ❑ Azithromycin 500 mg OR ❑ Clarithromycin 500 mg | ❑ Ampicillin 2 g IM or IV OR ❑ Cefazolin 1 g IM or IV OR ❑ Ceftriaxone 1 g IM or IV | ❑ Cefazolin 1 g IM or IV OR ❑ Ceftriaxone 1 g IM or IV OR ❑ Clindamycin 600 mg IM or IV | ||||||||||||||||||||||||||||
References
- ↑ Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M; et al. (2007). "Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group". Circulation. 116 (15): 1736–54. doi:10.1161/CIRCULATIONAHA.106.183095. PMID 17446442.
- ↑ 2.0 2.1 "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.