Infective endocarditis prophylaxis: moving from dental prophylaxis to global prevention?
Summary of "Infective endocarditis prophylaxis: moving from dental prophylaxis to global prevention?"
Infective endocarditis (IE) is an infectious disease which mainly affects elderly patients. Staphylococcus aureus is the main microorganism and IE, which used to be associated with a previously known heart disease, is now associated with healthcare procedures. For a long time, it was thought necessary to prevent IE with antibiotics before starting many invasive procedures. But in the last few years, there has been a change, with a drastic limitation on the situations in which antibiotic prophylaxis is required. Epidemiological studies emphasize changes in the profile of IE, which is moving from a streptococcal disease in patients with previously known heart disease to a staphylococcal healthcare-associated disease in elderly patients suffering from many comorbidities or having intracardiac devices. These changes should lead us to question the validity of our current management of antibiotic prophylaxis. There are already recommendations from the American Heart Association (AHA) for the prevention of implantable cardiovascular electronic device implantation, but apart from this particular situation, should we not extend prophylaxis to more comprehensive prevention in patients who have comorbidities? To find an answer, we need to acquire more data on the pathophysiology of IE while continuing epidemiological surveillance of the disease.
Affiliation
Centre Hospitalier Universitaire de Besançon, Besançon, France.
Journal Details
This article was published in the following journal.
Name: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Micro
ISSN: 1435-4373
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22354523
- DOI: http://dx.doi.org/10.1007/s10096-012-1564-3
Medical and Biotech [MESH] Definitions
Dental Hygienists
Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist.
Warfarin
An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.
Dental Prophylaxis
Treatment for the prevention of periodontal diseases or other dental diseases by the cleaning of the teeth in the dental office using the procedures of DENTAL SCALING and DENTAL POLISHING. The treatment may include plaque detection, removal of supra- and subgingival plaque and calculus, application of caries-preventing agents, checking of restorations and prostheses and correcting overhanging margins and proximal contours of restorations, and checking for signs of food impaction.
Nitrofurantoin
A urinary anti-infective agent effective against most gram-positive and gram-negative organisms. Although sulfonamides and antibiotics are usually the agents of choice for urinary tract infections, nitrofurantoin is widely used for prophylaxis and long-term suppression.
Endocarditis, Subacute Bacterial
ENDOCARDIUM infection that is usually caused by STREPTOCOCCUS. Subacute infective endocarditis evolves over weeks and months with modest toxicity and rare metastatic infection.
PubMed Articles
Relationship between odontogenic infections and infective endocarditis.
Revised guidelines for the prevention of infective endocarditis published by national and international associations in the last years do not support the indiscriminate use of antibiotic prophylaxis f...
The goal of this study was to evaluate temporal trends in infective endocarditis (IE) incidence and clinical characteristics after 2002 French IE prophylaxis guideline modifications.
Diagnosis and treatment of infective endocarditis : Current ESC guidelines.
To account for the current evidence in the field of infective endocarditis and to harmonize deviant national guidelines, in 2009 the European Society of Cardiology published novel recommendations on t...
Endocarditis prophylaxis and congenital heart defects in the Norwegian Public Dental Service.
AIMS: i) to assess how dental health workers of the Public Dental Service, PDS, carry out endocarditis prophylaxis related to dental treatment of children and adolescents with congenital heart defects...
Objective The National Institute for Health and Clinical Excellence (NICE) introduced the antibiotic prophylaxis guideline in 2008 for cardiac patients in the UK, which has led to a decrease in nation...
Clinical Trials
Cardiac Computarized Tomography in Infective Endocarditis
The diagnosis of infective endocarditis is based on the results of blood culture and findings on transeosophageal echocardiography. Cardiac computarized tomography is a new modality, mainl...
How to Improve Diagnosis in Infective Endocarditis
The purpose is to exam prospective if simple clinical information in combination with a normal s-procalcitonin are sufficient for exclusion of infective endocarditis (IE).
Retrospective Review of Management of Infective Endocarditis
This is an analysis of the outcomes of patients having undergone surgical intervention for infective endocarditis.
Autoantibodies and Clinical Symptoms in Infective Endocarditis Patients
The purpose is to evaluate autoantibodies in infective endocarditis patients before, at the beginning of treatment, and after the end of the treatment, and to correlate the autoantibodies...
Fosfomycin Plus Imipenem for Treatment of Infective Endocarditis
The study evaluates the efficacy and safety of fosfomycin and imipenem for the treatment of methicillin-resistant staphyloccocus aureus infective endocarditis in comparison to vancomycin,...
