ALL suspected/ confirmed cases of endocarditis MUST be discussed with Microbiologists and Cardiologists and entered to the IE Care Pathway form.
Discuss with Microbiologist at first opportunity in working hours and daytime during the weekend (within 24 hours of suspected diagnosis)
Three sets of blood cultures need to be taken before initiating antibiotics. If antibiotics already started, blood culture must be collected before next dose of antibiotic. Must LABEL BC AS ENDOCARDITIS for prolonged incubation and endocarditis specific sensitivity testing and MIC determinations.
Serology for Coxiella and Bartonella if blood culture negative endocarditis.
- Valve tissue at operation in sterile container without saline and inform the laboratory prior to delivery and deliver by hand to member of the senior laboratory staff for 16s rRNA PCR and other specialist molecular tests.
- The below recommendations are for empiric therapy only. Targeted regimes will be provided by Consultant Microbiologist and Cardiologist.
- Vancomycin plus Gentamicin may accentuate renal impairment.