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Infective Endocarditis — SCE Infectious Diseases MCQ

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HardBone & Joint InfectionInfective EndocarditisSCE Infectious Diseases

A 55-year-old man is diagnosed with penicillin-susceptible Streptococcus sanguinis native valve endocarditis (MIC to Penicillin 0.06 mg/L). TOE shows a 6 mm vegetation on the mitral valve with mild regurgitation. No complications. He has normal renal function. What is the shortest evidence-based treatment course?

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Correct answer: E — 2 weeks of IV Ceftriaxone plus IV Gentamicin (short-course combination)

For fully penicillin-susceptible (MIC ≤0.125 mg/L) streptococcal native valve endocarditis without complications (no abscess, no heart failure, no large vegetation, no emboli, normal renal function), a short 2-week regimen of IV beta-lactam (Ceftriaxone or Penicillin) plus IV Gentamicin is an established option per ESC 2023 and AHA guidelines. This must only be used in uncomplicated NVE — prosthetic valve endocarditis always requires at least 6 weeks.

Reference: ESC 2023 – Endocarditis guidelines; BSAC 2012 – Endocarditis treatment