Prevention of Bacterial Endocarditis

Abstract

Major changes in the updated recommendations include the following: (1) emphasis that most cases of endocarditis are not attributable to an invasive procedure; (2) cardiac conditions are stratified into high-, moderate-, and negligible-risk categories based on potential outcome if endocarditis develops; (3) procedures that may cause bacteremia and for which prophylaxis is recommended are more clearly specified; (4) an algorithm was developed to more clearly define when prophylaxis is recommended for patients with mitral valve prolapse; (5) for oral or dental procedures the initial amoxicillin dose is reduced to 2 g, a follow-up antibiotic dose is no longer recommended, erythromycin is no longer recommended for penicillin-allergic individuals, but clindamycin and other alternatives are offered; and (6) for gastrointestinal or genitourinary procedures, the prophylactic regimens have been simplified. These changes were instituted to more clearly define when prophylaxis is or is not recommended, improve practitioner and patient compliance, reduce cost and potential gastrointestinal adverse effects, and approach more uniform worldwide recommendations.

Infective Endocarditis in Childhood: 2015 Update

“…AHA guidelines have long proposed that maintaining oral health may be important in the overall effort to prevent IE, 67,69 and there is increasing support from studies that report a frequent occurrence of bacteremia with toothbrushing (39%-46%). 42,55,68 It has also been suggested that chewing food may result in bacteremia, but there are no studies to confirm this in children.…”

Infective Endocarditis in Elderly: From Etiology to Treatment and Prevention

“…Риск развития ИЭ увеличивается при наличии митральной регургитации любого генеза за счет повреждающего воздействия на клапаны так назы-ваемых "срезающих сил" (shear forces), обусловлен-ных патологическим током крови и его турбулент-ностью в районе створок [17,18]. Кальцификация кольца митрального клапана, часто наблюдающаяся у пожилых лиц и почему-то среди женщин, также является дополнительным фактором риска развития ИЭ [18][19][20][21][22][23].…”

Die infektiöse Endokarditis bei Intensivpatienten

“…Vor Herzkatheteruntersuchungen oder elektrophysiologischen Untersuchungen (EPU) ist eine routinemäßige antibiotische Prophylaxe nicht notwendig [9]. Eine antibiotische Abschirmung bei der Anlage zentralvenöser Zugänge erbringt keine Vorteile im Sinne einer Reduktion katheterassoziierter Bakteriämien [38].…”