How is bacterial endocarditis treated?

Once endocarditis occurs, quick treatment is necessary to prevent damage to the heart valves and more serious complications, such as death. As soon as the blood cultures have been secured the patient is started on intravenous (IV) antibiotic therapy (broad spectrum), covering as many as possible of suspected bacterial species. The antibiotics are adjusted to the sensitivity of the organism that grows from the blood culture as soon as that is available. IV antibiotics is usually given for as long as 6 weeks to cure of the infection. Symptoms are monitored throughout therapy and blood cultures are repeated to determine the effectiveness of treatment.

If heart valve and heart damage has occurred, surgery may be required to fix the heart valve and improve heart function.

After treatment is completed, the patient should be worked up for sources of bacteremia and these (for example, dental infections) should be treated. In the future, the patient should take antibiotics prophylactically according to guidelines (see Prevention).

Last reviewed by a Cleveland Clinic medical professional on 04/29/2019.

References

  • Nishimura, RA, et. al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart DiseaseA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129 (23) e521-e643. https://www.ahajournals.org/doi/full/10.1161/cir.0000000000000031 Accessed 12/2018
  • Nishimura, RA, et. al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017; 135 (25) e1159-e1195. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000503 Accessed 12/2018
  • Habib G, et. al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) The Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). European Heart Journal (2009) 30, 2369–2413 doi:10.1093/eurheartj/ehp285 http://eurheartj.oxfordjournals.org/content/ehj/30/19/2369.full.pdf Accessed 12/2018
  • Wilson W, et. al. 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. 2007;116:1736-1754 http://circ.ahajournals.org/content/116/15/1736.full.pdf Accessed 12/2018

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