Required Investigations

  • Blood cultures: 3 sets (10ml per bottle), spaced 30mins apart, from 3 different sites.
  • Obtain cardiology opinion.

Antibiotic Recommendation

Antibiotics should not be started unless the patient has sepsis with organ dysfunction

Call Microbiology before initiating treatment.

Recommended total duration: Varies with organism & severity.

Notes

Likely organisms: Streptococci, Staphylococci

  • If asked to start gentamicin, use Synergistic Gentamicin protocol. Do not use the standard gentamicin chart.
  • If endocarditis confirmed antimicrobial treatment is likely to be several weeks; consider siting a midline or PICC.
  • The purpose of separate blood cultures in time and site is to identify a persisting bacteraemia, a hallmark of endocarditis.
  • In prosthetic valve endocarditis if the diagnosis is unclear after 3 sets, consider taking a further 3 sets of blood cultures.