How to prevent infective endocarditis in 2020? Practical issues.

How to prevent infective endocarditis in 2020? Practical issues. Kardiol Pol. 2020 Aug 12;: Authors: Brubert J, Cahill TJ, Prendergast BD Abstract The incidence of infective endocarditis (IE) continues to rise in many populations and is typically accompanied by a shift to healthcare-associated staphylococcal species. Despite efforts with aggressive antibiotic therapy and increasing rates of surgical intervention, little progress has been made to reduce mortality. Disease prevention is therefore a crucial part of limiting its effects. Prevention should target each point in the pathogenic triad of IE; initiating bacteraemia, adhesion to substrate, and proliferation of pathogenic species. Preventative strategies must focus on at-risk patients undergoing high risk procedures, and these patients and procedures can now be identified by quantitative risk estimates. The attendant risk resulting from a procedure must then be placed in the perspective of the day-to-day risk, and the resulting balance can inform the benefit of prophylactic antibiotics. Implantable devices are a major risk factor for IE, and novel coatings and designs may be effective in risk-reduction. Guidelines differ worldwide and a consensus has yet to be reached on whom should receive pre- and peri-procedural antibiotics. PMID: 32788568 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research