Causes. Subacute bacterial endocarditis (SBE) is usually caused by streptococcal species (especially viridans streptococci), and less often by staphylococci.
What does SBE prophylaxis mean?
The rationale of prophylactic antibiotic therapy for subacute bacterial endocarditis are the following: Infective endocarditis is a fatal disease, and prevention is preferable to treatment of established infection. Specific cardiac conditions predispose to infective endocarditis.
What bacteria causes subacute bacterial endocarditis?
Subacute bacterial endocarditis is usually caused by streptococcal bacteria. This form of the disease usually develops on damaged valves after dental surgery involving infected gums, reproductive or urinary (genitourinary tract) surgery or operations on the gastrointestinal tract.
What is sub acute bacterial endocarditis?
Subacute bacterial endocarditis is a type of infective endocarditis. It’s an infection that occurs when germs such as bacteria enter the bloodstream and attack the lining of the heart valves. This causes growths, called vegetations, on the heart valves.
How is SBE diagnosed?
Your doctor will usually order a blood test and a blood culture. A blood culture can sometimes identify the specific type of bacteria causing your infection. A standard blood test can reveal a low red blood cell count, which is a common symptom of SBE. Other tests include echocardiography.
What antibiotics treat endocarditis?
Initial empiric therapy in patients with suspected endocarditis should include vancomycin or ampicillin/sulbactam (Unasyn) plus an aminoglycoside (plus rifampin in patients with prosthetic valves). Valve replacement should be considered in selected patients with infectious endocarditis.
Who needs infective endocarditis prophylaxis?
High-risk individuals to whom antibiotic prophylaxis should be provided are as follows [4,5 ]: Patients with prosthetic valves (including transcatheter valves) and patients who have undergone valve repair in whom a prosthetic material is used. Patients with a history of previous infective endocarditis.
What antibiotics are used for dental prophylaxis?
Amoxicillin and clindamycin were prescribed most frequently for infection prophylaxis (71.3% and 23.8% of antibiotic prescriptions, respectively). The other antibiotics prescribed for dental procedures included amoxicillin-clavulanate (3.1%), azithromycin, metronidazole, and trimethoprim-sulfamethoxazole (each <1%).
When do you give SBP prophylaxis?
Prophylaxis should begin after the completion of antibiotic therapy for SBP (norfloxacin 400 mg daily) and should continue until resolution of ascites, liver transplantation, or death. Patients with cirrhosis who are admitted for upper GI hemorrhage should also receive antibiotic prophylaxis.
Can endocarditis be cured?
In many cases of endocarditis, antibiotics alone can cure the infection. However, in about 25-30 percent of patients with IE, surgery is needed during the early acute phase of infection due to severe valve leakage or failure to control the infection with antibiotics.
How fast does endocarditis develop?
There are two forms of infective endocarditis, also known as IE: Acute IE — develops suddenly and may become life threatening within days. Subacute or chronic IE (or subacute bacterial endocarditis) — develops slowly over a period of weeks to several months.
How long can subacute endocarditis last?
Conclusions: Long term survival following infective endocarditis is 50% after 10 years and is predicted by early surgical treatment, age < 55 years, lack of congestive heart failure, and the initial presence of more symptoms of endocarditis.
What are the complications of endocarditis?
As a result, endocarditis can cause several complications, including:
- Heart problems, such as heart murmur, heart valve damage and heart failure.
- Pockets of collected pus (abscesses) that develop in the heart, brain, lungs and other organs.
- Blood clot in a lung artery (pulmonary embolism)
- Kidney damage.
Why does dental work cause endocarditis?
A dental problem or procedure that results in an infection can trigger it. Poor health in the teeth or gums increases the risk of endocarditis, as this makes it easier for the bacteria to get in. Good dental hygiene helps prevent heart infection.
What is the difference between acute and subacute endocarditis?
Acute infective endocarditis develops suddenly and may become life threatening within days. Subacute infective endocarditis (also called subacute bacterial endocarditis) develops gradually and subtly over a period of weeks to several months but also can be life threatening.