Endocarditis | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Lothian
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Blood stream infections and endocarditis
Endocarditis

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

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.