Cardiobacterium Treatment & Management

Updated: Jun 04, 2019
  • Author: Kerry O Cleveland, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Treatment

Medical Care

Until recently, the HACEK bacteria were uniformly susceptible to ampicillin. Recently, however, beta-lactamase–producing strains of HACEK have been identified.

A third-generation cephalosporin (ceftriaxone or cefotaxime) should be considered the drug of choice for HACEK endocarditis.

Ampicillin plus an aminoglycoside can be used for susceptible isolates.

In patients unable to take beta-lactams, options include trimethoprim-sulfamethoxazole, fluoroquinolones, or aztreonam.

Native valve endocarditis should be treated for 3-4 weeks. Prosthetic valve endocarditis requires 6 weeks of treatment.

The American Heart Association recommends treatment with ceftriaxone, ampicillin-sulbactam, or ciprofloxacin for 4 weeks.

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Prevention

Antibiotic prophylaxis given prior to dental procedures is primarily directed at Streptococcus viridans but should also help prevent infection due to HACEK bacteria. [14]

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Further Outpatient Care

Patients with C hominis endocarditis can be treated in an outpatient setting but should remain on intravenous antimicrobial therapy for the duration of treatment.

Risks of embolic complications may arise during therapy.

Patients should be continuously and carefully monitored and should have prompt access to medical care, including cardiac surgery, in the event of complications.

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Further Inpatient Care

Native valve endocarditis should be treated for 4 weeks. Prosthetic valve endocarditis requires 6 weeks of treatment.

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