Effective antibiotic therapy increases the prognosis of endocarditis. Since accurate identification of the causative agent is critical to successful treatment, blood cultures are collected to determine the exact organism. Patients with fungal endocarditis may benefit from early valve replacement followed by at least 6 weeks of antibiotic therapy.
Antibiotic therapy may take 4-6 weeks to completely eradicate the infecting organism. Subsequent blood cultures are collected to determine the effectiveness of therapy.
Lesions may break off the endocardium and enter the bloodstream as emboli. Anticoagulant therapy decreases the risk of thrombus formation. Blood stasis found in patients with a low ejection fraction especially benefit from anticoagulant medications.
Good hygiene is critical for preventing infections that may lead to endocarditis. Teach the patient about the importance of daily oral hygiene and regular dental visits to prevent infections. Instruct the patient to avoid people with an infection and to report symptoms of cold, flu, or cough to the healthcare provider.
Endocarditis has a high likelihood for recurrent infection and complications. Monitoring the patient is critical to determine the need for additional treatment or medication.
Patients diagnosed with endocarditis will receive antibiotic prophylaxis for the remainder of their lives to decrease the risk of bacterial infection. Antibiotics are prescribed before undergoing dental or invasive procedures. Patients with a history of congenital or valvular heart disease will also receive antibiotic prophylaxis to prevent the development of endocarditis.
Patients with certain heart conditions undergoing dental procedures require antibiotic prophylaxis to prevent endocarditis. Heart conditions include prosthetic heart valve repair, congenital heart disease, cardiac transplantation, and previous history of infective endocarditis. Dental manipulation may cause the bacteria normally found in the mouth to travel down to the heart and cause endocarditis. Dental work includes manipulation of gums, roots of the teeth, and puncture of the oral mucosa. Dental procedures requiring prophylactic antibiotics include dental extractions, implants, and cleaning (dental hygiene).
Patients with certain heart conditions undergoing invasive procedures require prophylactic antibiotic therapy to prevent endocarditis. Inform the patient about the importance of antibiotic prophylaxis before invasive procedures, such as catheterization, cystoscopy, endoscopy, and surgery.
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