heart and blood vessel disorders
Infective Endocarditis
Treatment of Infective Endocarditis
Antibiotics given by vein (intravenously) Sometimes heart surgery Treatment usually consists of at least 2 weeks and often up to 8 weeks of antibiotics given by vein (intravenously) in high doses. Antibiotic therapy is almost always started in the hospital but may be finished at home with the help of a home nurse. Some people with certain types of infection may be able to switch to antibiotics taken by mouth after a period of intravenous treatment. Antibiotics alone do not always cure an infection, particularly if the valve is one that has been replaced. One reason is that the bacteria that cause endocarditis in a person with a replacement valve are often resistant to antibiotics. Because antibiotics are given before heart valve replacement surgery to prevent infection, any bacteria that survive this treatment to cause infection are probably resistant. Another reason is that it is generally harder to cure infection on artificial, implanted material than in human tissue. Heart surgery may be needed to repair or replace damaged valves, remove vegetations, or drain abscesses if antibiotics do not work, a valve leaks significantly, or a birth defect connects one chamber to another. Dental treatment to eliminate any sources of infection due to mouth or gum disease is usually needed. Doctors usually also remove any devices (such as catheters) that may be a source of infection. Doctors may use a series of echocardiography examinations to ensure that the infected area is decreasing. They may also do echocardiography at the end of treatment to have a record of the appearance of heart valves because infective endocarditis may recur. Because of the risk of recurrence, ongoing dental care and good skin hygiene (to prevent any bacteria from entering the body through sores or wounds) is needed. 