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تعداد آیتم قابل مشاهده باقیمانده : -15 مورد

Antibiotic management of Bartonella endocarditis in adults not undergoing valve surgery

Antibiotic management of Bartonella endocarditis in adults not undergoing valve surgery
This algorithm is for patients not underoing valve surgery; indications for valve surgery are discussed in UpToDate content on Bartonella endocarditis. Oral administration of antibiotics is typically adequate for the entire course of therapy, with the exception of gentamicin which does not have an oral option. Our suggested antibiotic approach is based on limited observational studies and on adverse effects of specific antibiotics.

IV: intravenous.

* Most patients can tolerate doxycycline, but some patients have signficant side effects (eg, nausea) or allergy.

¶ Some patients cannot take rifampin due to drug interactions or intolerance (eg, flu-like symptoms, liver enzyme abnormalities). If significant drug interactions are present, options are to avoid rifampin or to discontinue or alter the dosage of the interacting drug. For specific recommendations, refer to the drug interactions program.

Δ Immune-complex glomerulonephritis has been increasingly reported in patients with endocarditis due to Bartonella spp, and often manifests as unexplained hematuria or proteinuria.

◊ Azithromycin causes QT prolongation, particularly in patients on other QT-prolonging medications and has been associated with increased cardiovascular mortality in observational studies. Refer to the UpToDate topic on azithromycin.

§ Some experts prefer gentamicin dosing of 1 mg/kg IV every 8 hours. Regardless of the dosing schedule, kidney function and gentamicin levels should be followed carefully. Refer to UpToDate content for details.
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