Are antibiotics always used?
Usually endocarditis is caused by bacteria, in these cases antibiotics are used for therapy. However, there are also forms of endocarditis that are triggered, for example, by an autoimmune reaction. Antibiotic therapy is then not recommended. Antibiotics are therefore almost always used in endocarditis, because endocarditis is almost always caused by bacteria in the bloodstream that attach themselves to the heart valves. The most common triggers are streptococci and staphylococci.
How long are antibiotics used?
In bacterial endocarditis, antibiotics are used until the endocarditis has healed. Depending on the pathogen, the age of the patient and the presence of an artificial heart valve, the duration is two to eight weeks. A permanent intake of antibiotics is usually not necessary after a bacterial endocarditis. However, after the bacterial infection has healed, patients should take antibiotic prophylaxis before e.g. dental surgery to prevent recurrence of endocarditis.
What do you do if you are allergic to penicillin?
Penicillin G is the standard medication in bacterial endocarditis caused by streptococci of the Viridans group or S. bovis. Other antibiotics can be used in the case of a penicillin allergy, in many cases these are so-called “reserve antibiotics”, which include vancomycin and teicoplanin, for example. These are actually reserved for use with pathogens with a high resistance to standard antibiotics, but are still used in cases of penicillin allergy and endocarditis.
What is an antibiogram?
An antibiogram is the result of an antibiotic resistance test of a pathogen. If a bacterium can be detected in a patient’s blood, for example, it is applied to an agar plate (a special laboratory plate for cultivating bacteria and other pathogens) for testing. Small plates with antibiotics are then placed on this plate.
Each of these antibiotic plates contains a different active ingredient. If a pathogen is resistant to a certain antibiotic, it can still grow in close proximity to this antibiotic platelet. If a certain antibiotic is effective against the pathogen to be tested, the pathogen cannot grow and a so-called “inhibition zone” is formed.
The size of the inhibition zone is measured and can be converted into the potency of the antibiotic against the pathogen. The antibiogram summarizes these results in a clear table and is an important aid in deciding which antibiotic therapy should be used.
