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Treatments and drugs
By Mayo Clinic staffThe first line of treatment for endocarditis is antibiotics. Sometimes, if your heart valve is damaged by your infection, surgery is necessary.
Antibiotics
If you have endocarditis, you may need high doses of intravenous (IV) antibiotics in the hospital. Blood tests may help identify the type of microorganism that's infecting your heart. This information will help your doctor choose the best antibiotic or combination of antibiotics to fight the infection.
You will usually need to take antibiotics for four to six weeks or longer to clear up the infection. Once your fever and the worst of your signs and symptoms have passed, you may be able to leave the hospital and continue IV antibiotic therapy with visits to your doctor's office or at home with home-based care. You'll need to see your doctor regularly to make sure your treatment is working.
Report to your doctor any signs or symptoms that your infection is getting worse, such as:
- Fever
- Chills
- Headaches
- Joint pain
- Shortness of breath
Diarrhea, a rash, itching or joint pain may indicate a reaction to an antibiotic — another reason to call your doctor.
See your doctor immediately if you experience shortness of breath or swelling in your legs, ankles or feet. These signs and symptoms may indicate heart failure.
Surgery
If the infection damages your heart valves, you may have symptoms and complications for years after treatment. Sometimes surgery is needed to treat persistent infections or to replace a damaged valve. Surgery is also sometimes needed to treat endocarditis that's caused by a fungal infection.
Depending on your condition, your doctor may recommend either repairing your damaged valve or replacing it with an artificial valve made of animal tissue or man-made materials.
- Infective endocarditis. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp. Accessed June 6, 2011.
- Endocarditis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/endo/endo_all.html. Accessed June 19, 2009.
- Sexton DJ. Diagnostic approach to infective endocarditis. http://www.uptodate.com/home/index.html. Accessed June 2, 2011.
- Sexton DJ. Epidemiology, risk factors and microbiology of infective endocarditis. http://www.uptodate.com/home/index.html. Accessed June 2, 2011.
- Spelman D, et al. Complications and outcome of infective endocarditis. http://www.uptodate.com/home/index.html. Accessed June 2, 2011.
- Sexton DJ. Antimicrobial therapy of native valve endocarditis. http://www.uptodate.com/home/index.html. Accessed June 2, 2011.
- Schick EC. Surgery for native valve endocarditis. http://www.uptodate.com/home/index.html. Accessed June 2, 2011.
- Delahaye F. Is early surgery beneficial in infective endocarditis? A systematic review. Archives of Cardiovascular Disease. 2011:104:35.
- Burton MJ, et al. Infective endocarditis prevention: Update on 2007 guidelines. The American Journal of Medicine. 2007;11:484.
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