【醫(yī)學(xué)課件】感染性心內(nèi)膜炎ppt課件-資料下載頁(yè)
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【正文】 term therapy is inappropriate if plicated by ostomyelitis, meningitis, myocardial abscess, or conitant leftsided involvement 7/98 23 New Treatments ? Highly penicillinsusceptible Streptococcus viridans or bovis – Oncedaily ceftriaxone for 4 wks ? cure rate 98% ? easily administered as outpatient, avoid hospitalization, offers significant cost savings – Oncedaily ceftriaxone 2 g for 2wks followed by oral amoxicillin qid for 2 wks – Oncedaily ceftriazone and ilmicin for 2 wks 7/98 24 New Treatments ? Prosthetic valve endocarditis due to fluconazolesusceptible Candida species – many are due to bloodstream invasion – chronic oral suppressive therapy with fluconazole for inoperable disease 7/98 25 SBE Prophylaxis Standard general prophylaxis amoxicillin Unable to take oral meds ampicillin Allergic to penicilin clindamycin cephalexin azithromycin clarithromycin Allergic to penicillin and unable clindamycin to take oral medications cefazolin 7/98 26 References ? Prevention of bacterial endocarditis. Remended by the American Heart Association. Dajani AS, Taubert KA, Wilson W, et al. Circulation 1997。96:358366 ? New Criteria for diagnosis of infective endocarditis: Utilization of specific echocardiographic findings. Durack DT, Lukes AS, Bright DK, et al. Am J Med 1994。96:200209 ? Antibiotic treatment of adults with infective endocarditis due to strptococci, enterococci, staphlococci, and HACEK microanisms. Wilson WR, Karchmer AW, Dajani AS. JAMA 1995。274:17061713
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