Possible Infective Endocarditis

Important: Notes

Always take blood cultures prior to starting antibiotic treatment. 

Obtain three sets over 24 hours, minimum 30 mins apart, with 10ml in each bottle.

Seek senior specialist advice.

Doses may need to be adjusted in renal impairment. Always check the BNF for interactions. Seek advice if patient pregnant.

Drug Specific Cautions:

1. Check interactions in the BNF. Caution may prolong QT interval.
2. Avoid / Caution in pregnancy or breastfeeding. Consult BNF for details.
3. Gentamicin/Vancomycin refer to online calculators.
4. ALERT Antibiotic - Consult Second line Policy on NHS Lanarkshire Guideline App.
5. Monitor sodium.
6. See CURB65 definition.
7. Reference: The Renal Drug Handbook. Online access.
8. See Fluoroquinolones MHRA guidance on NHS Lanarkshire Guidelines App.
9. Doxycycline and quinolones decreased absorption with iron, calcium, magnesium and some nutritional supplements. See BNF appendix 1 or pharmacy for advice.
10. Caution in renal impairment – see BNF or pharmacy for advice.
11. Use with caution may increase K+ and decrease renal function. Monitor.
12. High / Excellent oral bioavailability, IV route available for NBM or vomiting.
13. See Co-trimoxazole information for prescribers’ safety sheet on NHS Lanarkshire Guidelines App.