Calculated initial parenteral treatment of bacterial infections: Bacterial endocarditis

Abstract

This is the twelfth chapter of the guideline "Calculated initial parenteral treatment of bacterial infections in adults - update 2018" in the 2^nd updated version. The German guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) has been translated to address an international audience. The bacterial endocarditis is characterised by a constant incidence but a shift in the patient population due to the use of prosthetic heart valves and foreign materials like pacemakers and the increasing application of invasive medical procedures. This is linked to a change in the predominant infecting organisms towards staphylococci. This chapter gives recommendations for the interdisciplinary management of infective endocarditis from the diagnostic workup over prevention to therapy with a focus on antibiotic therapy.

Table 1. Empiric treatment of culture-negative bacterial endocarditis with prior antibiotic treatment or until blood culture results are ready. For culture-negative endocarditis without prior antibiotic treatment, an infection expert should be consulted.

Table 2. Overview of the common antibiotics for bacterial endocarditis