Final answer:
Endocarditis prophylaxis is essential for individuals at the highest risk, such as those with prosthetic heart valves or a history of heart damage. Antibiotics are administered to prevent infection during procedures that may introduce bacteria into the bloodstream. Treatment involves antibiotics like ampicillin, nafcillin, and vancomycin, with rifampin for prosthetic-valve cases.
Step-by-step explanation:
Prophylaxis for infective endocarditis is recommended only for patients at the highest risk. Those include individuals with preexisting heart conditions such as prosthetic heart valves or other cardiac devices, and patients with a history of endocarditis or heart damage due to rheumatic fever. During procedures that can introduce bacteria into the bloodstream, such as dental work, body piercings, catheterization, or surgery, these patients may require antibiotics to prevent endocarditis.
Antibiotics commonly used for treatment include ampicillin, nafcillin, and gentamicin in acute cases, targeting Staphylococcus spp. and Streptococcus spp. In prosthetic-valve endocarditis, a combination of vancomycin, rifampin, and gentamicin is often used. Rifampin is essential for its ability to penetrate the biofilm protecting pathogens on prosthetic devices.