Penicillin-resistant Streptococci Treatment Recommendations
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Questions and Answers

What is the recommended treatment duration for aminoglycoside therapy in penicillin-resistant cases of infective endocarditis?

  • Exactly 2 weeks
  • More than 2 weeks (correct)
  • Can vary based on patient stability
  • Less than a week
  • What is recommended when a patient with infective endocarditis caused by resistant isolates is clinically stable after 10-14 days of therapy?

  • Increase the dosage of antibiotics
  • Continue the same treatment indefinitely
  • Consider switching to daptomycin therapy
  • Consider OPAT or outpatient oral antibiotic therapy (correct)
  • What percentage of patients in the retrospective series were treated with penicillin or ceftriaxone for infective endocarditis caused by penicillin-resistant streptococci?

  • 78% (correct)
  • 10%
  • 30%
  • 50%
  • What is indicated if a patient has infective endocarditis caused by resistant isolates and is not clinically stable after 10-14 days of therapy?

    <p>Consider IV antibiotic treatment in the hospital</p> Signup and view all the answers

    What is the incidence of resistant S.mitis and Streptococcus oralis reported in large strain collections?

    <p>&gt;30%</p> Signup and view all the answers

    Which antibiotic therapy is not recommended for short-term regimens in penicillin-resistant cases?

    <p>Aminoglycosides alone</p> Signup and view all the answers

    What is the recommended treatment for penicillin-susceptible strains without meningitis?

    <p>Short-term 2-week therapy</p> Signup and view all the answers

    In cases of meningitis, why should penicillin be avoided?

    <p>Poor penetration into cerebrospinal fluid</p> Signup and view all the answers

    For infective endocarditis caused by group A streptococci, what is their susceptibility to beta-lactams?

    <p>Susceptible to beta-lactams</p> Signup and view all the answers

    What is recommended when treating infective endocarditis due to the Streptococcus anginosus group?

    <p>Beta-lactam antibiotics alone</p> Signup and view all the answers

    After 10-14 days of therapy for meningitis cases, what treatment option should be considered if the patient is clinically stable?

    <p>Outpatient oral antibiotic therapy</p> Signup and view all the answers

    What is the recommended treatment when encountering penicillin-resistant strains without meningitis?

    <p>Cefotaxime or ceftriaxone alone or in combination with vancomycin</p> Signup and view all the answers

    What is the mortality rate associated with group B infective endocarditis?

    <p>Exceeding 50%</p> Signup and view all the answers

    Which streptococci induce infective endocarditis with large vegetations and high rates of complications?

    <p>Groups B, C, and G streptococci</p> Signup and view all the answers

    What antibiotic is no longer recommended for staphylococcal native valve endocarditis due to increased renal toxicity?

    <p>Aminoglycoside</p> Signup and view all the answers

    In penicillin-allergic patients with MSSA endocarditis, what antibiotic can be used if beta-lactams are contraindicated?

    <p>Cefazolin</p> Signup and view all the answers

    In infective endocarditis caused by Staphylococcus aureus, what is the preferred treatment if vancomycin is deemed inferior to beta-lactams?

    <p>Daptomycin</p> Signup and view all the answers

    What is the rationale behind adding rifampin after 3–5 days of effective antibiotic therapy once the bacteraemia has been cleared in Staphylococcus aureus endocarditis?

    <p>To enhance antibiotic activity and prevent resistance development</p> Signup and view all the answers

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