Document Detail

Swedish guidelines for diagnosis and treatment of infective endocarditis.
MedLine Citation:
PMID:  18027277     Owner:  NLM     Status:  MEDLINE    
Swedish guidelines for diagnosis and treatment of infective endocarditis (IE) by consensus of experts are based on clinical experience and reports from the literature. Recommendations are evidence based. For diagnosis 3 blood cultures should be drawn; chest X-ray, electrocardiogram, and echocardiography preferably transoesophageal should be carried out. Blood cultures should be kept for 5 d and precede intravenous antibiotic therapy. In patients with native valves and suspicion of staphylococcal aetiology, cloxacillin and gentamicin should be given as empirical treatment. If non-staphylococcal etiology is most probable, penicillin G and gentamicin treatment should be started. In patients with prosthetic valves treatment with vancomycin, gentamicin and rifampicin is recommended. Patients with blood culture negative IE are recommended penicillin G (changed to cefuroxime in treatment failure) and gentamicin for native valve IE and vancomycin, gentamicin and rifampicin for prosthetic valve IE, respectively. Isolates of viridans group streptococci and enterococci should be subtyped and MIC should be determined for penicillin G and aminoglycosides. Antibiotic treatment should be chosen according to sensitivity pattern given 2-6 weeks intravenously. Cardiac valve surgery should be considered early, especially in patients with left-sided IE and/or prosthetic heart valves. Absolute indications for surgery are severe heart failure, paravalvular abscess, lack of response to antibiotic therapy, unstable prosthesis and multiple embolies. Follow-up echocardiography should be performed on clinical indications.
Katarina Westling; Ewa Aufwerber; Christer Ekdahl; Göran Friman; Bengt Gårdlund; Inger Julander; Lars Olaison; Christina Olesund; Hanna Rundström; Ulrika Snygg-Martin; Anders Thalme; Maria Werner; Harriet Hogevik
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  39     ISSN:  0036-5548     ISO Abbreviation:  Scand. J. Infect. Dis.     Publication Date:  2007  
Date Detail:
Created Date:  2007-11-20     Completed Date:  2008-03-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  929-46     Citation Subset:  IM    
Infective Endocarditis Working Group, Swedish Society of Infectious Diseases, Sweden.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use*
Endocarditis / diagnosis*,  drug therapy*
Practice Guidelines as Topic*
Reg. No./Substance:
0/Anti-Bacterial Agents

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