[Antibiotic treatment of infectious endocarditis]

Abstract

Background: Infective endocarditis is a septic condition in which the heart valves and the endocardial surfaces are infected, causing bacteraemia. In Norway, infective endocarditis is the most common infectious disease of the heart and accounts for approximately one case per 1,000 hospital admissions. The mortality rate is 15-40%.

Material and methods: This article presents a review of antimicrobial treatment of infective endocarditis, based on relevant literature and the author's clinical experience. Prophylactic treatment is not described.

Results and interpretation: Early start of antimicrobial treatment is extremely important in order to avoid destruction of the heart valves and should always be started as soon as endocarditis is suspected and blood cultures have been drawn. The patient must be treated with bactericidal antibiotics in high doses given intravenously for four to eight weeks, depending on the aetiologic agents and the response. Only antibiotics that have been proven effective against endocarditis should be used. The minimal inhibitory concentration (MIC) should be determined for all antibiotics used.