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How do you decide on the timing and number of blood cultures for suspected endocarditis given the differences in recommendations between the ESC guidelines and the Duke Criteria?

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Infectious Disease · The Cleveland Clinic Foundation

Concern about differences in recommendations regarding specifics of blood culture collection between the two guidelines should be alleviated if one understands that these are guidelines, not dictates.

It would help to lay out general principles. First, the focus of infection in infective endocarditi...

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Infectious Disease · Beebe Infectious Disease

Excellent discussion above. My real-world points:

  1. Unfortunately by the time I'm notified of the consult (ID), the ER has already started antibiotics, and I'm fortunate if they've at least done 2 sets BCxs - they'll never do 3. If there is Staph endocarditis, there will be no problem recovering the ...

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Infectious Disease · Nebraska Medical Center

Thank you, Dr. Shrestha for the insightful comments.

The ESC guidelines recommend obtaining at least three sets of blood cultures, each containing 10ml, and the rationale behind such recommendations is the data on the sensitivity of the blood culture sets. Studies in the 2000s showed that sampling b...

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Infectious Disease · Duke University

Interesting discussion with valid points. In writing the 2023 Duke ISCVID Criteria, we had a lot of discussion on this very point. In the end, the differences between the 2023 ESC and 2023 Duke ISCVID criteria arise from the ultimate goals of each Criterion. The Duke Criterion is primarily a researc...

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