Infective endocarditis

It is used for bacterial infections caused by microorganisms that are sensitive to the drug. These may be abdominal and gynecological infections, sepsis, meningitis, endocarditis, infections of the urinary and respiratory tracts, bones, joints, skin, and soft tissnes. It is widely nsed for pneumonia as well as bacterial meningitis in children, and for post-operational infections complications. Synonyms of this drug are ceftin, zinacef, curoxim, kefox, and many others. 

Indications Anthrax, cellulitis, endocarditis, infections, otitis media, rheumatic fever, respiratory infections, septicemia Category Antibiotic, penicillin Half-life 4 hours... 

Carbon C, Cremieux A-C, Fantin B. Pharmacokinetics and pharmacodynamic aspects of therapy of experimental endocarditis. Infect Dis Clin North Am 1993 7 37-51. 

EUopoUs GM. Aminoglycoside resistant enterococcal endocarditis. Infect Dis CUn North Am 1993 7 117-133. 

Houpikian P, Raoult D. Diagnostic methods current best practices and guidelines fot identification of difficult-to-culture pathogens in infective endocarditis. Infect Dis Clin N Am. 2007 16 377-392. 

Moreillon, P., et ah, Role of Staphylococcus aureus coagulase and clumping factor in pathogenesis of experimental endocarditis. Infect Immun 1995, 63, 4738-4743. 

In addition, dmg abusers rarely use aseptic techniques for administering drags intravenously which can lead to localized and systemic infections such as endocarditis (infection of the lining of the heart), HIV, and sepsis (infection of the entire circulatory system). Drag abusers also incur cellulitis (infection in the tissues), sclerosis (scaring of the veins), phlebitis (irritation of veins), and skin abscesses. 

Peacock MG, Philip RN, Williams JC, et al. Serological evaluation of Q fever in humans Enhanced phase I titers of immunoglobulins G and A are diagnostic for Q fever endocarditis. Infect Immun. 1983 41 1089-1098. 

Infection. It has been estimated that 1% of implanted cardiac devices become infected. Infections can range from device pocket infections to endocarditis. Infections usually occur early after implantation and are caused by introduction of bacteria into the surgical wound, but can also occur years after implantation... 

Tuberculosis is on the increase in developed countries such as the USA and UK furthermore, MAI may be associated with AIDS sufferers. Hospital-acquired opportunistic mycobacteria may cause disseminated infection and also lung infections, endocarditis and pericarditis. Transmission of mycobacterial infection by endoscopy is rare, despite a marked increase in the use of flexible fibreoptic endoscopes, but bronchoscopy is probably the greatest hazard for the transmission ofM tuberculosis and other mycobacteria. Thus, biocides used for bronchoscope disinfection must be ehosen carefully to ensure that such transmission does not occur. 

Ischemic stroke has numerous causes. Cerebral infarction may result from large artery atherosclerosis, cardiac embolism, small artery lipohyalinosis, cryptogenic embolism, or, more rarely, from other diverse conditions such as arterial dissection, infective endocarditis, and sickle cell disease. Arterial occlusion is the cause of at least 80% of acute cerebral infarctions. " ... 

Hart RG, Foster JW, Luther MF, Kanter MC. Stroke in infective endocarditis. Stroke 1990 21 695-700. 

Antimicrobials also can be classified as possessing bactericidal or bacteriostatic activity in vitro. Bactericidal antibiotics generally kill at least 99.9% (3 log reduction) of a bacterial population, whereas bacteriostatic antibiotics possess antimicrobial activity but reduce bacterial load by less than 3 logs. Clinically, bactericidal antibiotics may be necessary to achieve success in infections such as endocarditis or meningitis. A full discussion of the application of antimicrobial pharmacodynamics is beyond the scope of this chapter, but excellent sources of information are available.15... 

Reculture of specimens is not performed routinely except in few cases (e.g., endocarditis) or where a secondary infection is suspected because data may be misleading and lead to the addition of broader or more powerful antimicrobials... 

Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis Diagnosis, antimicrobial therapy, and management of complications a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association endorsed by the Infectious Diseases Society of America. Circulation 2005 111(23) 394M34. 

O For infective endocarditis to develop, the occurrence of several factors is required. These factors involve alterations to the endocardial surface that allow for bacterial adherence and eventual infection. 

Infective endocarditis (IE) is a serious infection affecting the lining and valves of the heart. While this disease is mostly associated with infection of the heart valves, the septal defects may become involved as well. Infections also occur in patients with prosthetic or mechanical devices, such as mechanical heart valves or who are intravenous drug users (IVDUs). Bacteria is the primary cause of IE however, fungi and atypical organisms also can be responsible pathogens. 

Reprinted from Bayer AS, Scheld WM, Endocarditis and intravascular infections. In Principles and Practice of Infectious Diseases, Vol 1, 5th ed., p. 870. Copyright 2000, with permission from Elsevier. 

FIGURE 71-1. Pathogenesis of infective endocarditis. (From Scheld W. In Atlas of Infectious Diseases External Manifestations of Systemic Infections. Philadelphia Current Medicine, Inc. Copyright 1997. Used with permission.)... 

Infective endocarditis caused by these streptococci typically has a subacute clinical course. The current cure rate is often over 90% unless complications occur, which is the case in more than 30% of patients.17 The majority of viridans streptococci remain very susceptible to penicillin, with most strains having a minimum inhibitory concentration (MIC) of less than 0.125 mcg/mL.15,18 Organisms with decreased susceptibilities are increasing. Therefore, antibiotic susceptibilities need to be assessed in order to determine the most appropriate treatment regimen. 

B. Modified Duke Criteria for the Diagnosis of Infective Endocarditis ... 

Firm alternate diagnosis explaining evidence of infective endocarditis, or... 

Resolution of infective endocarditis syndrome with antibiotic therapy for less than or equal to 4 days, or... 

Does not meet criteria for possible infective endocarditis, as above... 

Reproduced, with permission, from AHA Scientific Statement Infective Endocarditis. 2005, American Heart Association. 

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