Treatment

The type of antibiotic used will be selected based on the type of microbe causing the endocarditis. High doses of antibiotics administered into a vein are used to treat cases of the disease caused by bacteria or fungi. This treatment requires hospitalisation for at least the first few weeks.  Once fever and other symptoms have subsided, it is possible for the intravenous therapy to be continued at home with daily monitoring of the patient by healthcare professionals, or at a hospital closer to the patient’s place of residence. In some cases, the treatment may be completed using oral antibiotics.    

If the endocarditis is caused by a fungus, a combination of antifungals is administered, also long-term and intravenously at first, and then orally for at least one year.   In some very specific, severe cases that cannot be operated on, it may be necessary to maintain oral antibiotic or antifungal treatment for life to ensure that the disease does not recur.

In some very specific, severe cases that cannot be operated on, it may be necessary to maintain oral antibiotic or antifungal treatment for life to ensure that the disease does not recur.

In almost half of patients, the damage caused to the heart valves or disruption to the proper functioning of the heart means the disease can only be fully cured by combining antibiotics or antifungals with heart surgery. In these cases, the heart surgeon will operate on the valves damaged by the infection and will remove the affected tissue.  

Depending on the findings in each case, the surgeon may recommend either repairing the damaged valve or replacing it with an artificial valve made from cow, pig or human tissue (a biological tissue valve) or a prosthetic mechanical (metal) valve. Heart surgery is a very complex procedure, but it has been shown that it is necessary in order to remove the infection and restore the heart’s valve function.