Complex Infectious Disease Care

Infective endocarditis (IE) requires prolonged IV antibiotic therapy, often 4-6 weeks, and close monitoring for complications such as embolic events, heart failure, and abscess formation. Our approach includes:

• Culture-directed antimicrobial therapy with pharmacokinetic optimization
• Coordination with cardiology and cardiac surgery when valve intervention is considered
• OPAT management for stable patients who qualify for outpatient therapy

Bone and joint infections often require a combination of surgical debridement and prolonged antimicrobial therapy. We work closely with orthopedic surgery to ensure appropriate source control and select regimens that achieve adequate bone penetration.

For prosthetic joint infections, management depends on factors including infection duration, pathogen virulence, and implant stability. Options range from debridement with implant retention (DAIR) to staged or single-stage exchange arthroplasty.

Central nervous system infections—including bacterial meningitis, brain abscess, and epidural abscess—require rapid diagnosis, appropriate empiric therapy, and often neurosurgical intervention. We provide:

• Guidance on empiric antibiotic selection pending CSF and culture results
• Optimization of regimens for CNS penetration
• Coordination with neurosurgery for abscess drainage when indicated

Invasive fungal infections and multidrug-resistant (MDR) bacterial infections present unique challenges requiring specialized expertise in antifungal pharmacology and novel antibiotic agents.

We manage infections caused by organisms including Candida auris, carbapenem-resistant Enterobacteriaceae (CRE), ESBL-producing organisms, and MRSA, using the latest evidence-based approaches and antimicrobial stewardship principles.