Treatment and Prevention
If a bacterium is causing endocarditis, your doctor will prescribe one or more antibiotics for 2 to 8 weeks. These antibiotics often have to be given by intravenous (IV) injection. If a fungus is the cause, an antifungal medication is given. These must usually be given by IV injection for 6 or more weeks. Heart surgery is sometimes needed for infective endocarditis, especially for people with prosthetic heart valves.
Non-infective endocarditis is treated with anticoagulants like warfarin* that help prevent further clots from developing.
To prevent infective endocarditis, be sure to let your doctor know if you have some of the risk factors described above in "Causes." This is important especially if you need to undergo surgery or dental work. If you are at a high risk for endocarditis, you may be prescribed antibiotics before surgery or dental work to reduce the risk of endocarditis, depending on the type of procedure you will be undergoing. It is extremely important to take these antibiotics as directed by your doctor.
Currently, recommended preventative antibiotics for dental procedures include:
- amoxicillin 2 g for adults, or 50 mg/kg for children, taken by mouth one hour prior to a dental procedure.
- for adults and children allergic to penicillin, clindamycin 600 mg for adults, or 20 mg/kg for children, taken by mouth one hour before procedure. Additional options include clarithromycin 500 mg for adults or 15 mg/kg for children taken by mouth one hour before procedure.
Other preventative measures include:
- Taking proper care of your teeth and gums is the single most important preventive measure you can take. The mouth is a common source of bacteria that can cause infection. Good oral hygiene cuts down on the amount of bacteria in the mouth and body overall.
- Watch for signs of bacterial infection if you're experiencing symptoms of the common cold or influenza (the flu). Early treatment of more minor ailments can go a long way to reducing the risk of endocarditis.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network.