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Treatment - valvular dysfunction Prevention No controlled...

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Treatment Proper identification of the causative organism and institution of effective antimicrobial therapy is essential for successful treatment of IE. Bacteria within vegetations are not easily killed by host defenses, thus an antimicrobial regimen that is bactericidal is required. To achieve high serum concentrations effective enough to penetrate deep into avascular vegetations, antibiotics are given parenterally. Synergistic combinations of antibiotics may be used initially to clear the bacteria from the blood stream more rapidly or for the duration of treatment for the more resistant bacteria such as Enterococci. Surgery for valve replacement may be necessary to treat antibiotic resistant organisms or severe
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Unformatted text preview: valvular dysfunction. Prevention No controlled studies have been completed to determine the efficacy of prophylactic antibiotics, but animal data suggest a role for such a strategy. The patients at highest risk of IE are those with known valvular abnormalities or prosthetic valves who undergo procedures that may lead to transient bacteremias such as dental cleaning or extraction or invasive gastrointestinal or genitourinary tract procedures. The type of antibiotic prophylaxis used depends on the type of procedure being performed and the risk of known pathogens at the site....
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