Treatment Overview
There are three main goals when treating
endocarditis:
- Quickly destroy the
infection.
- Repair or replace a heart valve, if
needed.
- Treat complications.
Destroy the infection
If you have endocarditis, you will need several weeks of treatment
with one or more antibiotics. Initially, you will be treated in the hospital
because the antibiotics are given through a vein (by IV), and you
may need additional tests during treatment. After your fever is gone and you
are stable, you may be able to continue IV antibiotics at home with the help of
a home health nurse.
Antibiotics are usually given for 4 to 8 weeks, but some people may
require only 2 to 4 weeks of treatment. How long you take antibiotics may
depend on what type of bacteria is causing the infection, or if you have an
infection of artificial heart valves. For example, you may take antibiotics for
a longer time because you have artificial heart valves. The antibiotics must be
given long enough and at a strong enough dose to destroy all of the
bacteria.
After the initial IV antibiotics, your doctor may want you to take
antibiotic pills. If so, it is very important that you take them exactly as
prescribed until they are gone. If your symptoms return, call your doctor right
away. You probably will need more antibiotics if testing shows that the
bacteria were not completely destroyed.
If endocarditis is caused by a fungus, you may need intravenous
antifungal medicine. And heart valve surgery usually is required for
endocarditis caused by a fungus.
Surgery
If your heart valve becomes severely damaged from
endocarditis or if infection develops in an artificial
heart valve, you may need surgery to repair or replace the valve.
You may need surgery if you have:
- Heart
failure.
- A fungal infection.
- An
abscess around a valve in your
heart.
- Damage to the electrical system of your
heart.
- Infected tissue that repeatedly breaks off the valve and
travels to other parts of your body (for example, lungs, brain, or
kidneys).
Complications
If you develop
complications from endocarditis, such as
heart failure or
stroke, you may need additional treatment for these
conditions.
Treatment for endocarditis is usually guided by an
infectious disease specialist. A
cardiologist may also be involved if your heart muscle
or valves are damaged. You will need a
cardiovascular surgeon if you have heart valve
replacement surgery.