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Post-Surgical IE Antibiotic Duration — SCE Infectious Diseases MCQ

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ModerateBone & Joint InfectionPost-Surgical IE Antibiotic DurationSCE Infectious Diseases

A 60-year-old man with prosthetic aortic valve endocarditis caused by MRSA undergoes successful valve replacement surgery. Post-operatively, he remains on IV Vancomycin. The surgeon asks how long antibiotics should continue after surgery. What is the recommendation?

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Correct answer: C — Restart the full antibiotic course duration from the date of surgery — at least 6 weeks post-operatively for prosthetic valve staphylococcal endocarditis

ESC 2023 endocarditis guidelines recommend that when valve surgery is performed for active IE, the antibiotic course should restart from the date of surgery. For prosthetic valve staphylococcal endocarditis, this means at least 6 weeks of IV antibiotics post-operatively. If intraoperative valve cultures are positive, the full course restarts from surgery. If cultures are negative (suggesting effective pre-operative sterilisation), some guidelines allow for a shortened post-operative course, but 6 weeks remains the standard for staphylococcal PVE.

Reference: ESC 2023 – Endocarditis; BSAC 2012 – Endocarditis