Cardiobacterium Treatment & Management

Updated: Feb 29, 2016
  • Author: Kerry O Cleveland, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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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.