Ceftriaxone or Penicillin G Sodium?

[adolescent]

Hi, I am from Bangladesh. They say my sister grew some vegetation on the heart. At first they suggested Penicillin G Sodium IV injection for 6 weeks but it wasn't available here locally. So we gave Oricef (Ceftriaxone) IV inj for 4 weeks and after that some improvements has been observed. In the meantime the Penicillin G Sodium injection has arrived from Canada. (Now 4 weeks is ending). So we need to continue injection for another two weeks.

Now question is which one will be better to give her, Oricef that we are continuing or the Penicillin G Sodium ?

Thanks for your suggestion.

[CCFHeartMD 12]

The answer depends on the bacteria that grew from your sister's blood.  In general ceftriaxone is a broad spectrum antibiotic covering gram-negative bacteria, while penicillin is narrower and covers mostly gram-positive.    But in cases of streptococcal endocarditis, they are both recommended.  So I think if she is improving from ceftriaxone already, I would finish the course of antibiotic with the same drug rather than switching.  

[adolescent]

Hi CCFHeartMD 12, Many thanks for your answer. It is really a decision making reply for us. But I don't know if she has 'streptococcal endocarditis'. Here is the description from her recent Color Doppler report:

Seen post intramural vegetation. Small vegetation (4x5mm, ? Sterile) seen inside RV attached to RV anterior wall. Mild pulmonary valve stenosis noticed. PPG: 18mmHg. Mild TR noticed. PPG: 25mmHg. Intact IAS and IVS. No PDA or coarctation seen. No intracardiac mass seen. Chamber dimensions and wall motion normal. All other valves and tracts are normal. No pericardial effusion is seen. Good biventricular function.