55yo M presenting with fevers and abdominal pain found to have MSSA bacteremia and endocarditis
Dr. Matt Scherer | Morning Report | 06/07/2017
When concerned about staphylococcal infection, must consider: where did it come from, and where has it gone?
To treat MSSA: beta-lactam therapy head-to-head is better than vancomycin. Between cefazolin, oxacillin, nafcillin - generally thought to be equivalent, although cefazolin may be more easily administered to patients with renal disease (e.g. on hemodialysis)
For left-sided native valve endocarditis, need to decide between antibiotics and surgery. Indications for surgery?
Valve dysfunction with associated heart failure symptoms
Persistent infection despite appropriate antibiotics (more controversial than first two)
Generally, patients will require 6 weeks of antibiotics after valve surgery
Posted 06/08/17 12:49:47 PM by Iheanacho (Obi) Emeruwa