Obtaining accurate blood culture data is a crucial part of diagnosing and managing infective endocarditis.
Do not initiate antibiotics in patients who are hemodynamically stable until blood cultures are obtained.
In patients who are hemodynamically stable with a subacute presentation, obtain at least three sets of blood cultures, drawn twelve hours apart, prior to initiation of antimicrobial therapy.
In patients who appear unwell but hemodynamically stable, obtain three sets of blood cultures over an hour prior to initiation of antimicrobial therapy.
In patients with sepsis or who are hemodynamically unstable, obtain at least three sets of blood cultures STAT and initiate empiric antimicrobial therapy.
SIRS criteria (Two of HR>90, tachypnea, Temp >38 or <36, WBC >12 or <4)
Collect at least one set of blood cultures from central line and/or arterial line if present.
Continue to collect blood cultures q24-48h following initiation of therapy to document clearance.
Role of Echocardiography
Modified Duke Criteria