Prophylaxis is aimed at viridans streptococci – Amoxicillin – 3 g orally 1 hr before the procedure. 1.5g 6h after initial dose
Penicillin Allergy 800 mg oral erythromycin ethyl succinate Or 1 g Erythromycin, stearate 2h before the procedure Or 300 mg of oral clindamycin 1 hr before the procedure followed by ½ the dose 6h after initial dose.
Genito urinary / Gastrointestinal procedure
- Prophylaxis directed against enterococci.
Ampicillin + Gentamicin
(3g) (1.5 mg/mg IV)
Amoxicillin as above (1.5 g 6 hr later)
Penicillin allergy – Vancomycin 1 gm IV over 1 hr starting 1 hr before procedure
+Gentamicin 1 mg / kg IV /IM – 1 hr before procedure.
|Culture directed therapy|
Streptococci with Penicillin MICs of < 0.1 µ g/ml
|Note: *Incidence of infective endocarditis continues to rise with a yearly incidence of approximate 15,000 to 20,000 new cases.,|
*Infective Endocarditis now represents the fourth leading cause of life – threatening infectious disease syndromes (after urosepsis, pneumonia, intra abdominal sepsis)
*The use of new clinical criteria, emphasizing echocardiography will certainly guide the practitioner in correct diagnosis of disease.
*Prompt recognition and management of major complications of Infective Endocarditis, such as heart failure, periannular extension of the infection, splenic abscess, Mycotic aneurysms are also essential to successful patient outcome.