How Endocarditis Is Treated: From Targeted Antibiotics to Valve Surgery in Selected Cases

It usually starts as an ordinary bad month. A low fever that will not quite leave, night sweats, a tiredness that makes the stairs feel longer than they used to. Then a blood test comes back with bacteria in it, an ultrasound of the heart shows something clinging to a valve, and a stranger in scrubs uses a word most people have never said out loud: endocarditis. The first question that follows is almost always the same. How is endocarditis treated, and how long will this take?

The honest answer is that it takes patience. Bacteria that have settled on a heart valve live inside a sticky fortress of platelets and fibrin where antibiotics struggle to reach, and the body’s own immune cells barely penetrate at all. Clearing that fortress takes weeks of steady, targeted medicine, and sometimes a surgeon’s hands.

This explainer walks through what actually happens: the tests that come first, why the drug choice waits for the lab, how the weeks unfold, when surgery enters the conversation, and what recovery genuinely looks like.

How is endocarditis treated? The short version before the detail

Endocarditis is an infection of the inner lining of the heart, most often the valves. Treating it rests on two pillars, and every patient gets the first one.

The first pillar is antibiotics given directly into a vein, chosen to match the specific microbe found in the blood and continued for weeks rather than days. According to the NHS, most people need antibiotics for around two to six weeks, starting in hospital. The exact length depends on which organism is involved, whether the valve is the person’s own or an artificial one, and how the infection responds.

The second pillar is surgery, and only some people need it. When infection destroys enough valve tissue to cause heart failure, when antibiotics cannot clear the bacteria, or when clumps of infected material threaten to break away and travel to the brain, a surgeon may repair or replace the valve, sometimes while antibiotics are still running.

Around those pillars sits a great deal of watching. Repeat blood cultures check whether the bloodstream is clearing. Repeat echocardiograms track the valve. Kidney function, hearing, and blood counts are monitored because the antibiotics involved can be hard on the body over several weeks.

Guidelines from the American Heart Association and European cardiology societies recommend that decisions be made by a multidisciplinary team, typically including cardiology, infectious diseases, cardiac surgery, and microbiology, because the trade-offs are rarely simple. What follows explains each piece in turn, but the core idea is this: endocarditis is treated slowly and specifically, and the plan is rebuilt as the evidence comes in.

What is actually happening on an infected heart valve

Picture the heart valve as a thin, elegant leaflet that opens and shuts roughly 100,000 times a day. Its surface is normally smooth enough that passing bacteria slide off. Damage changes that. A valve scarred by earlier disease, stiffened with age, replaced by a prosthesis, or roughened by a pacemaker lead gives bacteria something to grip.

Bacteria enter the bloodstream constantly in small numbers: during dental work, from a skin infection, through an intravenous line, or with injection drug use. Most of the time the immune system clears them within minutes. If a few cling to a damaged valve, the body responds by laying down platelets and fibrin, the same protein mesh that forms a scab. The bacteria multiply inside that mesh, and the result is a vegetation, a soft clump of microbes and clot stuck to the valve.

This is why endocarditis is so stubborn. Inside a vegetation, bacteria are packed at extraordinary density, many in a slow-growing dormant state that antibiotics kill poorly. White blood cells cannot burrow in. The Cleveland Clinic and Johns Hopkins both describe this shielding as the reason treatment needs prolonged, high blood concentrations of antibiotic rather than a short course.

Vegetations cause harm in three ways. They chew through leaflet tissue, so the valve leaks and the heart labors. Fragments break off and travel downstream, lodging in the brain, kidneys, spleen, or limbs as emboli, small plugs that block blood flow. Infection can also tunnel into the tissue around the valve to form an abscess, a walled pocket of pus that may disturb the heart’s electrical wiring.

Every treatment decision, from the antibiotic choice to the timing of surgery, aims at one of these three problems.

Why blood cultures and an echocardiogram come before the right antibiotic

A tempting instinct when someone is feverish and unwell is to start antibiotics immediately. In suspected endocarditis, teams often take a deliberate pause of an hour or two first, and there is good reason for it.

The pause is for blood cultures: samples of blood placed in bottles of nutrient broth to see what grows. The Mayo Clinic describes them as the test that identifies the bacteria or fungi responsible. Several sets are drawn from different sites over a short period, because a single positive bottle might be skin contamination while repeated positives point firmly at the bloodstream. Even one antibiotic dose given before the cultures can suppress growth enough to hide the organism, leaving the team to treat blind for weeks.

The second essential test is an echocardiogram, an ultrasound of the heart. The standard version places a probe on the chest. When the picture is unclear or a prosthetic valve is involved, a transesophageal echocardiogram passes a slim probe down the food pipe to sit directly behind the heart, giving a far sharper view of vegetations and abscesses. Both the NHS and Mayo Clinic list echocardiography as central to confirming the diagnosis.

Other investigations fill in the picture. An electrocardiogram checks for conduction problems that can signal an abscess near the wiring. Blood tests measure inflammation and kidney function. A CT or MRI of the brain or body may be ordered if emboli are suspected, and in prosthetic-valve cases a nuclear scan can sometimes show infection the ultrasound misses.

Once the cultures are in the incubator and the echo is done, antibiotics begin at once, first as a broad regimen covering the likeliest organisms, then narrowed as soon as the lab reports back.

Endocarditis antibiotics: how the choice is made and why it changes

People often ask which antibiotic treats endocarditis, expecting a single name. The truthful answer is that the drug depends on the organism, and the organism is not known on day one.

Three groups of bacteria cause most cases. Staphylococci, especially Staphylococcus aureus, are now the single most frequent cause in many high-income countries and tend to produce aggressive, fast-moving infections. Streptococci, many of which live harmlessly in the mouth, cause a slower, smoldering form. Enterococci, gut bacteria, are the third major group and are notoriously resistant to many antibiotics. Fungi are rare but serious, and a minority of cases grow nothing at all, which complicates everything.

The laboratory does more than name the microbe. It tests which antibiotics kill it and at what concentration. That susceptibility report shapes the regimen. A penicillin-type drug may be chosen for a sensitive streptococcus; a different class may be needed for a resistant staphylococcus; for some organisms two antibiotics are combined because together they kill bacteria that neither clears alone. When an artificial valve is infected, guidelines generally add a drug that penetrates the biofilm coating on prosthetic material.

None of these choices belong to the patient or the article. They belong to the prescribing team, guided by the culture, the valve type, kidney function, allergies, and published guidance from bodies such as the American Heart Association.

What patients can usefully understand is the logic. The regimen is intravenous because gut absorption cannot reliably deliver the sustained blood levels the vegetation demands. Blood tests during treatment track kidney function and, for some drugs, blood levels, because the very antibiotics that reach the valve can strain the kidneys or affect hearing over several weeks. When something is adjusted mid-course, it is usually because a result came back, not because the plan failed.

How long is endocarditis treatment? Understanding treatment duration

Endocarditis treatment duration is the question that shapes people’s lives for the next season: work, childcare, travel, sleep. The NHS puts the typical antibiotic course at two to six weeks. Where an individual lands within that range follows a fairly consistent logic.

Shorter courses sit at the lower end for uncomplicated infections on a person’s own valve caused by highly sensitive streptococci. Longer courses toward the upper end are usual for staphylococcal infection, for enterococci, and for anything involving a prosthetic valve, where bacteria hide in the biofilm on artificial material. Fungal endocarditis generally needs prolonged antifungal treatment and very often surgery.

An important detail trips people up: the clock usually starts from the first day blood cultures come back negative, not from the first antibiotic dose. If the bloodstream takes several days to clear, those days do not count toward the course. If surgery removes infected tissue and the tissue itself grows bacteria, some teams restart the count from the operation.

Why weeks rather than days when the fever often settles much sooner? Because feeling better means the free-floating bacteria are gone, not the dormant ones buried in the vegetation. Stopping early risks a relapse that is harder to treat, as the Cleveland Clinic and Mayo Clinic both note in their guidance on completing the full course.

There is genuine research interest in switching carefully selected, stable patients to oral antibiotics part-way through, and trial evidence supporting that approach for specific situations has influenced European guidance. It is not standard for everyone and depends on organism, valve, and response. Any change of that kind is a decision for the treating team, weighed against the individual’s results.

Can endocarditis be treated at home? Outpatient IV antibiotics explained

Six weeks in a hospital bed sounds unbearable, and for many patients it is not necessary. The NHS notes that once someone is stable, the rest of the intravenous course can often be completed at home, an arrangement known as outpatient parenteral antibiotic therapy, or OPAT.

Here is how it typically works. A long, thin catheter called a PICC line is threaded into a vein in the upper arm and advanced until its tip sits in a large vein near the heart. It stays in place for the whole course, so daily needles are avoided. Antibiotics are then given either by a visiting nurse, at a daily infusion clinic, or by the patient or a family member after training, sometimes using a small portable pump that runs continuously in a pouch.

Not everyone is eligible straight away. Teams generally want to see that fever has settled, blood cultures have turned negative, there is no sign of heart failure or brewing complication, and the home situation is safe. People whose infection is caused by Staphylococcus aureus, who have a prosthetic valve, or who may need surgery are often kept in longer because the first weeks are when complications most commonly appear.

Home treatment does not mean less monitoring. Weekly or more frequent blood tests track kidney function, blood counts, and inflammation. A clinician reviews the line site for redness or leakage, because a PICC line is itself a potential route for new infection or clots. Patients are usually told to call immediately if fever returns, the arm swells, or the line stops flushing.

Whether OPAT is appropriate, and when, is a judgment for the infectious diseases and cardiology team. For those who qualify, it turns a long treatment into something closer to ordinary life.

When does endocarditis need heart valve surgery?

Endocarditis valve surgery frightens people, and the reasoning behind it deserves a plain explanation. Antibiotics kill bacteria; they cannot rebuild a leaflet that infection has eaten through, drain an abscess, or remove a vegetation that has not shrunk. Surgery exists for the problems medicine alone cannot fix.

Guidelines from the American Heart Association and European cardiology societies describe three broad reasons an operation is recommended.

• Heart failure. When a valve leaks severely or is obstructed, the heart cannot keep up, fluid backs into the lungs, and breathlessness follows. This is the most common and most urgent surgical indication.
• Uncontrolled infection. Signs include an abscess or fistula forming around the valve, infection with a fungus or a highly resistant organism, persistent positive blood cultures despite appropriate antibiotics, or infection that has loosened a prosthetic valve.
• Embolism risk. Large vegetations, especially those that have already thrown a fragment to the brain or elsewhere, carry a high chance of doing so again. Removing them removes the source.

The operation itself is open-heart surgery on a bypass machine. The surgeon cuts away all infected tissue, drains any abscess, and either repairs the valve using the patient’s remaining tissue or replaces it with a mechanical or biological prosthesis. Repair is often preferred when possible because it avoids lifelong anticoagulation, though infected tissue frequently leaves too little to work with.

Timing is the hardest judgment. Operating during active infection means sewing into inflamed tissue and carries real risk, including bleeding, stroke, kidney injury, and heart block requiring a pacemaker. Waiting risks the heart weakening further or a stroke occurring. The Mayo Clinic notes that surgery is sometimes performed while antibiotics are still being given, and that decision is made case by case.

Who usually goes to surgery early, and who is usually asked to wait

Two patients with the same diagnosis can be advised very differently, and that is not inconsistency. It is the guideline framework doing what it should.

Early surgery, sometimes within days, is generally recommended when heart failure is present or developing, when an abscess has formed, when the organism is a fungus or is resistant to available antibiotics, or when a large vegetation has already caused a stroke or other embolic event and the risk of another is high. In these situations, guidelines treat delay as the greater danger.

Others are asked to wait, and waiting is an active decision. A person with a small vegetation, a sensitive organism, a valve that still works, and blood cultures that cleared promptly may never need an operation at all. Their echocardiograms are repeated during treatment to make sure nothing is changing. If the picture stays stable, antibiotics alone finish the job.

Some people are asked to wait even though surgery is likely. Someone who has had a recent large stroke or a bleed into the brain from an infected artery is often held back, because putting a freshly injured brain on a bypass machine with blood thinners can worsen the damage. Surgeons and neurologists weigh how long to defer, and that interval is individualized rather than fixed.

Frailty, severe lung or kidney disease, and other conditions that make open-heart surgery unusually dangerous push the balance toward prolonged antibiotics with close monitoring, accepting a less complete solution because the alternative is riskier. Conversely, a younger person with a destroyed valve may be offered surgery sooner precisely because their recovery prospects are good.

None of these categories are rigid. Guidelines set the framework; the team applies it to the person in front of them, and the patient’s own values belong in that conversation.

Antibiotics alone versus valve surgery: a side-by-side summary

The two pillars of endocarditis treatment are not rivals. Everyone receives antibiotics; surgery is added for specific reasons. The table below lays out how they differ in purpose, process, and risk, drawing on descriptions from the NHS, Mayo Clinic, and American Heart Association.

Aspect	Intravenous antibiotics	Valve surgery
What it does	Kills bacteria in the bloodstream and, slowly, within the vegetation	Physically removes infected tissue, drains abscesses, restores valve function
Who receives it	Every patient with confirmed endocarditis	Those with heart failure, uncontrolled infection, or high embolism risk
Typical timeline	Around two to six weeks (NHS), often partly at home	Several hours in the operating room; days in intensive care; weeks of recovery alongside continued antibiotics
Main risks	Kidney strain, hearing changes with certain drugs, allergic reactions, line infections or clots, gut disturbance	Bleeding, stroke, kidney injury, heart block needing a pacemaker, infection of the new valve, general anesthetic risks
What it cannot do	Rebuild destroyed leaflets or drain a walled abscess	Replace the need for antibiotics; a full course still follows
Follow-up	Blood tests during treatment; echocardiogram at completion	Lifelong valve surveillance; anticoagulation if a mechanical valve is used

One line in that table deserves emphasis: surgery never replaces antibiotics. After an operation, the antibiotic course continues, often restarted from the day of surgery if the removed tissue grows bacteria. People sometimes hope that an operation means a faster route out of treatment. In practice it usually means two treatments running together.

The alternatives are also worth stating plainly. For someone who cannot undergo surgery, prolonged antibiotics with close monitoring is the alternative, accepting that a damaged valve may need attention later. For someone who declines surgery despite a recommendation, teams will explain the specific risk that is being accepted, and that choice remains the patient’s to make with full information.

What the following days and weeks of endocarditis treatment usually look like

The first week is the busiest. Blood cultures are repeated, often every day or two, until they come back negative. Fever is charted. An echocardiogram is repeated if anything changes clinically. Kidney function is checked frequently because several of the antibiotics used are cleared by the kidneys and can burden them. If the organism is a staphylococcus or a prosthetic valve is involved, the team stays especially alert for new murmurs, breathlessness, or neurological symptoms, since these signal that surgery may be moving from possible to necessary.

Many people feel markedly better within the first stretch of treatment as the bacteria in the bloodstream are cleared. This is genuinely good news and genuinely misleading. The vegetation is still there, and the course must run its length.

Once stable, the middle weeks often move home or to daily clinic visits with a PICC line, as described earlier. Life is oddly ordinary and oddly constrained: no swimming or soaking the arm, no heavy lifting on that side, regular blood draws, a vigilance about temperature. Fatigue is common and can linger; the body has been fighting a serious infection and is now processing weeks of strong medication.

Toward the end, an echocardiogram is generally repeated to record what the valve looks like after treatment. This becomes the baseline against which any future concern is measured. The line is removed. Some teams draw blood cultures after antibiotics stop to confirm the bloodstream stays clear.

For people who had surgery, the arc is different. Days in intensive care, then a ward, then home with a sternal wound that takes weeks to knit, cardiac rehabilitation, and, for a mechanical valve, learning to live with anticoagulant monitoring. The antibiotic course runs in parallel.

Recovery of energy after the course ends is often slower than people expect. That is not failure; it is the normal aftermath of a prolonged illness.

Can endocarditis come back? Preventing a second episode

Having had endocarditis once is among the strongest risk factors for having it again, because the valve that was vulnerable remains vulnerable, and a repaired or replaced valve carries its own risk. The Cleveland Clinic and NHS both stress that prevention after treatment is lifelong.

The single most useful habit is dental care. The mouth harbors streptococci that enter the bloodstream during chewing, brushing, and especially dental procedures. Gum disease multiplies those episodes. Twice-daily brushing, daily cleaning between teeth, and regular dental check-ups reduce the bacterial load and the frequency of bloodstream seeding. This is unglamorous advice, and it is the advice cardiologists give most often.

Antibiotic prophylaxis before dental work, a single protective dose taken beforehand, was once recommended widely. Guidelines from the American Heart Association now reserve it for people at highest risk, including those with a prior episode of endocarditis, a prosthetic valve or prosthetic repair material, certain congenital heart conditions, and some heart transplant recipients. Whether it applies to a given person, and what it involves, is a conversation for the cardiologist and dentist. UK guidance takes a more restrictive stance, which is why advice can differ across countries.

Skin is the other gateway. Treating skin infections promptly, keeping cuts clean, and avoiding tattoos and piercings in unsterile settings all matter. For people who inject drugs, endocarditis risk is substantial and recurrent; the NHS notes this as a major risk group, and access to addiction treatment and sterile equipment is part of medical prevention, not a moral aside.

Finally, knowing the early pattern matters. Fever without an obvious cause in someone who has had endocarditis should prompt blood cultures before any antibiotic is started, and patients are usually encouraged to say so to any clinician who sees them.

What people often get wrong about how endocarditis is treated

Myths gather around any frightening diagnosis. These are the ones clinicians correct most often.

“Once the fever is gone, the infection is gone.” Fever reflects bacteria circulating in the blood. The vegetation on the valve persists long after the fever breaks, which is exactly why courses run for weeks. Stopping early because one feels well is the classic path to relapse.

“Everyone with endocarditis needs open-heart surgery.” Surgery is for specific complications. Many people with sensitive organisms and intact valves complete antibiotics and never see a surgeon.

“Surgery means I can skip the antibiotics.” The opposite. Antibiotics continue after an operation, and the course may be counted afresh from surgery day.

“It only happens to people who inject drugs.” Injection drug use is a real and rising risk factor, but the majority of cases occur in older adults with degenerative valve disease, people with prosthetic valves or cardiac devices, those on dialysis, and people with prior valve damage. Anyone can develop it after a bloodstream infection.

“A dental cleaning caused it, so I should avoid the dentist.” Everyday chewing and brushing seed the blood with mouth bacteria far more often than the occasional dental visit. Neglected teeth raise risk; good dental care lowers it.

“Oral antibiotics would work if the doctors just prescribed them.” Intravenous delivery achieves reliable, sustained blood levels that a vegetation demands. Oral completion is being studied and is used in carefully selected stable patients under specialist guidance, not as a shortcut.

“Endocarditis is contagious.” It is not passed between people. The bacteria involved are common; the vulnerability is in the individual heart.

Correcting these matters because each one, believed, leads to a decision that makes treatment harder.

Questions to ask your care team about endocarditis treatment

A hospital conversation about endocarditis usually happens when a person is exhausted and frightened, and the questions that matter arrive later, at 3 a.m. Writing them down helps. These are the ones that tend to unlock the most useful answers.

• Which organism did my blood cultures grow, and how sensitive is it to the antibiotics I am receiving?
• Is the infection on my own valve or on a prosthetic valve or device, and how does that change the plan?
• How many weeks of antibiotics do you expect, and from what date is the course being counted?
• What did the echocardiogram show about the size of the vegetation and how well the valve is working?
• Are there any signs right now that point toward surgery, and what would change your mind in either direction?
• If surgery is recommended, would the aim be repair or replacement, and what kind of valve would be used?
• Which blood tests are you monitoring during treatment, and what would an abnormal result mean for me?
• Am I a candidate for finishing intravenous antibiotics at home, and what would need to be true first?
• What symptoms should make me call immediately rather than wait for my next appointment?
• After treatment ends, what follow-up scans or visits will I need, and for how long?
• Will I need antibiotic protection before dental work in future, and who should I tell?
• Who is coordinating my care across cardiology, infectious diseases, and surgery, and how do I reach them?

Asking a clinician to explain their reasoning is not challenging them. Teams following guideline-based, multidisciplinary care expect these questions, and the answers form a record you can refer back to when memory blurs, which it will. Bringing a family member or friend to key conversations, or asking permission to record them, is entirely reasonable.

When to call your doctor: warning signs of endocarditis during and after treatment

Endocarditis is a condition where speed matters twice: once at diagnosis, and again whenever something shifts during treatment or recovery. The following signs should prompt an immediate call to the treating team, or emergency services where noted.

Call emergency services for sudden weakness or numbness on one side of the body, facial drooping, slurred speech, confusion, a sudden severe headache, sudden loss of vision, or chest pain with breathlessness. These can signal an embolus to the brain or a rapidly failing valve, both of which need hospital assessment within minutes, not hours.

Contact your team the same day if fever returns after it had settled, if you develop new shortness of breath, cannot lie flat without breathlessness, or wake gasping at night, if your ankles or abdomen swell, or if you notice a fast or irregular heartbeat. Sudden pain in the abdomen, back, or a limb, or a limb that turns pale and cold, can indicate an embolus elsewhere in the body.

For those with a PICC line, redness, swelling, warmth, or pain in the arm, fluid leaking from the site, or a line that will not flush all need prompt review, since line infection or clot is a recognized risk of home intravenous treatment.

After the course is complete, the pattern that first announced the illness deserves the most respect. The NHS describes persistent fever, chills, night sweats, unexplained tiredness, aching joints and muscles, and unexpected weight loss as the common early features of endocarditis. Anyone who has had it before, or who has a prosthetic valve or device, should ask that blood cultures be taken before antibiotics are started for an unexplained fever, and should tell any clinician their history.

None of this is meant to alarm. Most days in treatment are uneventful. The point is that when something does change, the right response is a phone call rather than a wait-and-see.

Frequently asked questions

What are the warning signs of endocarditis?

The most common early features are a persistent fever, chills, night sweats, unexplained tiredness, aching muscles and joints, and weight loss, according to the NHS. Because these overlap with many ordinary illnesses, the pattern that matters is fever that will not settle in someone with a heart valve problem, a prosthetic valve or device, or a history of endocarditis. Sudden breathlessness or stroke-like symptoms are emergencies.

How long can a person live with endocarditis?

Without treatment, endocarditis is almost always fatal, as the Mayo Clinic and NHS both state, because the infection progressively destroys the valve and seeds other organs. With prompt antibiotics and surgery where needed, many people recover and return to normal life. Outcomes depend heavily on the organism, whether a prosthetic valve is involved, how quickly treatment started, and complications such as heart failure or stroke. The treating team can discuss an individual’s situation.

Can endocarditis be completely treated so it goes away?

Yes, in many cases a full course of targeted antibiotics, with surgery where indicated, clears the infection completely and a follow-up echocardiogram confirms a stable valve. What does not go away is the underlying vulnerability: a valve that was infected once, or that has been repaired or replaced, remains at higher risk. That is why lifelong dental care and prompt evaluation of unexplained fever are part of the plan.

What is the number one cause of endocarditis?

Bacteria cause the great majority of cases, and Staphylococcus aureus is now the single most frequent organism in many high-income countries, followed closely by streptococci from the mouth and enterococci from the gut. The bacteria reach the valve through the bloodstream after entering via the mouth, skin, an intravenous line, or injection drug use. Fungi are a rare but serious cause, usually in people with prosthetic valves or weakened immunity.

Which endocarditis antibiotics are used, and why can't I just take pills?

The antibiotic is chosen to match the specific organism and its laboratory sensitivity, so there is no single standard drug. Intravenous delivery is used because a vegetation on the valve demands sustained high blood levels that oral absorption cannot reliably provide. Switching stable, carefully selected patients to oral treatment part-way through is being studied and used in some settings, but that decision rests with the specialist team.

Does everyone with endocarditis need valve surgery?

No. Surgery is recommended for specific complications: heart failure from a damaged valve, infection that persists or forms an abscess despite antibiotics, or large vegetations with a high risk of breaking off. Many people with a sensitive organism, a working valve, and blood cultures that cleared promptly complete antibiotics alone. Repeat echocardiograms during treatment help the team decide whether the picture is changing.

How long do you stay in hospital for endocarditis treatment?

The NHS describes treatment starting in hospital with intravenous antibiotics, with many people able to finish the course at home once stable. The hospital portion varies widely: people with aggressive organisms, prosthetic valves, or possible surgery are kept longer because complications cluster in the early weeks. A full course typically spans two to six weeks in total, though the split between hospital and home is individual.

Is endocarditis contagious?

No. Endocarditis is not passed from person to person. The bacteria involved are common organisms that most people carry harmlessly on the skin, in the mouth, or in the gut. The problem arises only when they reach a damaged or artificial heart valve through the bloodstream and are able to cling on. Family members and visitors need no special precautions beyond ordinary hand hygiene.

Why do doctors keep asking about my teeth?

Because the mouth is the most common source of the streptococci that infect heart valves. Chewing, brushing, and dental work all push small numbers of bacteria into the blood, and gum disease multiplies those episodes. Good daily dental hygiene and regular check-ups lower the risk of a first or repeat infection. For highest-risk patients, guidelines may also advise a protective antibiotic before certain dental procedures.

What is different about treating endocarditis on a prosthetic valve?

Artificial valves are coated by bacteria in a biofilm that antibiotics penetrate poorly, so courses tend to run toward the longer end and often include an additional drug that reaches biofilm. Infection can also loosen the valve from its sewing ring or form an abscess around it, which is why surgery is more often needed. A transesophageal echocardiogram is usually required because standard ultrasound sees prosthetic material poorly.

References

• NHS — Endocarditis: Treatment
• Cleveland Clinic — Endocarditis
• MedlinePlus — Endocarditis

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.