GGC Medicines

Adult Therapeutics Handbook



  • If native valve, refer to the NHSGGC poster above for empirical endocarditis treatment. There is separate treatment guidance for prosthetic valve.  
  • Consider in Person Who Injects Drugs (PWID) / Intravenous Drug User (IVDU), line related sepsis, or recent dental extraction.
  • Prior to antibiotic treatment take three sets of blood cultures. For each set send blood culture in aerobic and anaerobic bottles.
  • Seek senior specialist advice, refer to cardiology and consider early cardiothoracic input, particularly in staphylococcal infections and infections involving a prosthetic valve.
  • Use synergistic dosing of gentamicin. For guidance on dose, monitoring and duration see guideline on NHSGGC StaffNet / Clinical Info / Clinical Guideline Directory (link only active if accessing via NHS computer) and search for 'Synergistic Gentamicin for Endocarditis in Adults'.
  • Discuss all suspected endocarditis cases with microbiology or infectious diseases unit within 72 hours.
  • Consider Out-patient Antibiotic Therapy (OPAT) referral after the first week of inpatient therapy.

Further management

Discuss further management with microbiology or infectious diseases unit (see Appendix 6 for contact details).


Content last updated January 2021