Antimicrobial therapy for bacterial endocarditis on native valves

Native valve endocarditis involves the left heart in 95% of cases with the mitral and aortic valves equally affected; on the right side, lesions are found predominantly on the tricuspid valve. A fever, a murmur (often changing) and embolic phenomena remain the most common clinical features in native...

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Bibliographic Details
Published in:The Journal of infection 1998-03, Vol.36 (2), p.137-139
Main Author: Littler, W.A.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Bacterial diseases
Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels
Biological and medical sciences
Blood - microbiology
Drug Therapy, Combination - therapeutic use
Endocarditis, Bacterial - drug therapy
Endocarditis, Bacterial - microbiology
Enterococcus - isolation & purification
Gram-Positive Bacterial Infections - drug therapy
Gram-Positive Bacterial Infections - microbiology
Heart Valve Diseases - drug therapy
Heart Valve Diseases - microbiology
Heart Valves - microbiology
Human bacterial diseases
Humans
Infectious diseases
Medical sciences
Staphylococcal Infections - drug therapy
Staphylococcal Infections - microbiology
Streptococcal Infections - drug therapy
Streptococcal Infections - microbiology
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Summary:Native valve endocarditis involves the left heart in 95% of cases with the mitral and aortic valves equally affected; on the right side, lesions are found predominantly on the tricuspid valve. A fever, a murmur (often changing) and embolic phenomena remain the most common clinical features in native valve endocarditis. In endocarditis heart valves may be damaged at an early stage, making prompt treatment essential. Blood cultures should be taken immediately when the diagnosis is considered and before commencing antibiotic therapy. Ninety per cent of positive cultures are obtained from the first two blood cultures and 95% of clinically significant bacteria are isolated from within 7 days of incubation. Gram-positive cocci are the commonest organisms isolated in over 90% of cases of infective endocarditis and include viridans streptococci, enterococci and staphylococci. Unusual organisms account for approximately 5% of cases of endocarditis and include the HACEX group of micro-organisms, Gram-negative cocci, brucella, coxiella, chlamydia, bartonella and fungi.
ISSN:0163-4453
1532-2742
DOI:10.1016/S0163-4453(98)80001-7