Infective endocarditis: 9 questions physicians often ask.

Antibiotic prophylaxis for endocarditis is strongly recommended for patients with intravascular hardware, including prosthetic valves, automatic implantable cardioverter defibrillators, pace-makers, and left ventricular assist de-vices. Polymerase chain reaction assays may help identify the culprit agent in culture-negative infective endocarditis (IE).Patients with Staphylococcus aureus bacteremia are at increased risk for IE and require aggressive evaluation. Several newer antistaphylococcal agents--including daptomycin, tigecycline, dalbavancin, and telavancin--show promise for the treatment of endocarditis caused by Gram-positive organisms. In patients with IE, the principal indications for valve repair or replacement are congestive heart failure from valve dysfunction; perivalvular extension, including new-onset conduction abnormalities; persistent fever for 10 or more days despite appropriate antibiotic therapy; large vegetation size; embolic phenomena; or infection with fungi, Pseudomonas aeruginosa, or S aureus. [ABSTRACT FROM AUTHOR]