Bacterial Endocarditis Prophylaxis: State of the Art
DOI:
https://doi.org/10.25751/rspa.17746Keywords:
Antibiotic Prophylaxis; Endocarditis, Bacterial/prevention & control; Practice Guidelines as TopicAbstract
Introduction: Recommendations for endocarditis prophylaxis have been updated over the last years with the intend of simplified it so that the number of people eligible would be less. Despite the scientific evidence available is short and weak, it was used to make the major recommendations (by American Heart Association - AHA, European Society of Cardiology - ESC and National Institute for Health and Care Excellence - NICE) and they have shown to be opposite from each other. In this study we aim to review the recent literature regarding endocarditis prophylaxis to promote the correct use of current recommendations.
Methods: This narrative revision was made using the database PubMed. A selection was made using the following keywords: "Endocarditis", "Prophylaxis", "Current evidence", "Clinical practice". The authors selected the studies.
Results/Discussion: The incidence of endocarditis is low (between 3 and 10 cases per 100 000) and varies between developed and developing countries. Over time, the approach of antibiotic prophylaxis has been shifted to a most restrictive sense, especially at the expense of modifying the definition of a high-risk patient.
Nowadays, doubt as to its real benefit still persists. On the one hand the lack of randomized and controlled studies, on the other hand, by the evidence of similar levels of bacteremia between invasive dental procedures and trivial oral hygiene measures.
Conclusion: According to the consensus of the current recommendations, a double conjugation of criteria should be applied in order to perform the prophylaxis, the existence of a high risk patient who will undergo a high risk procedure.
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References
2. Thornhill MH, Dayer M, Lockhart PB, Prendergast B. Antibiotic prophylaxis of infective endocarditis. Curr Infect Dis Rep. 2017;19:9. doi: 10.1007/s11908-017-0564-y.
3. Allen UD. Prevention of infective endocarditis: Updated guidelines. Paediatr Child Health. 2010;15:205-8; updated 2018.
4. Pant S, Patel NJ, Deshmukh A, Golwala H, Patel N, Badheka A, et al. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015;65:2070-6. doi: 10.1016/j.jacc.2015.03.518.
5. Selton-Suty C, Célard M, Le Moing V, Doco-Lecompte T, Chirouze C, Lung B, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012;54:1230-9. doi: 10.1093/cid/cis199.
6. Olmos C, Vilacosta I, Fernández-Pérez C, Bernal JL, Ferrera C, García-Arribas D,et al. The evolving nature of infective endocarditis in spain: a populationbased study (2003 to 2014). J Am Coll Cardiol. 2017;70:2795-804. doi: 10.1016/j. jacc.2017.10.005.
7. Fowler VG Jr, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E, et al. Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA. 2005; 293:3012-21. doi: 10.1001/jama.293.24.3012.
8. Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36:3075–128. doi: 10.1093/eurheartj/ehv319.
9. Arvay A, Lengyel M. Incidence and risk factors of prosthetic valve endocarditis. Eur J Cardiothorac Surg. 1988; 2:340-6.
10. Hill EE, Herregods MC, Vanderschueren S, Claus P, Peetermans WE, Herijgers P. Management of prosthetic valve infective endocarditis. Am J Cardiol. 2008; 101:1174-8. doi: 10.1016/j.amjcard.2007.12.015.
11. Calderwood SB, Swinski LA, Waternaux CM, Karchmer AW, Buckley MJ. Risk factors for the development of prosthetic valve endocarditis. Circulation. 1985; 72:31-7.
12. Grover FL, Cohen DJ, Oprian C, Henderson WG, Sethi G, Hammermeister KE. Determinants of the occurrence of and survival from prosthetic valve endocarditis. Experience of the Veterans Affairs Cooperative Study on Valvular Heart Disease. J Thorac Cardiovasc Surg. 1994; 108:207-14.
13. Kaplan EL, Anthony BF, Bisno A, Drack D, Houser H, Millard DH, et al. Prevention of bacterial endocarditis. Circulation. 1977;56:139A–43.
14. Dajani AS, Taubert KA, Wilson W, Bolger AF, Bayer A, Ferrieri P, et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. Circulation. 1997;96:358–66.
15. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116:1736–54.
16. National Institute for Health and Care Excellence (NICE). Prophylaxis against infective endocarditis. Secondary Prophylaxis against infective endocarditis. 2015. [consultado Jan 2019]. Disponível em: https://www.nice.org.uk/guidance/cg64/resources/endorsed-resource-antibiotic-prophylaxis-againstinfective-endocarditis-6535433773
17. Durack DT. Prevention of infective endocarditis. N Engl J Med. 1995; 332:38-44.
18. Dayer MJ, Jones S, Prendergast B, Baddour LM, Lockhart PB, Thornhill MH. Incidence of infective endocarditis in England, 2000–13: a secular trend, interrupted time-series analysis. Lancet. 2015;385:1219–28. doi: 10.1016/S0140-6736(14)62007-9.
19. Thornhill MH, Dayer MJ, Prendergast B, Baddour LM, Jones S, Lockhart PB. Incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis. J Antimicrob Chemother. 2015;70:2382–8.
20. Franklin M, Wailoo A, Dayer M, Jones S, Prendergast B, Baddour LM, et al. The cost-effectiveness of antibiotic prophylaxis for patients at risk of infective endocarditis. Circulation. 2016;134:1568-1578.
21. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop
guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:2395-451. doi: 10.1161/CIRCULATIONAHA.108.190811.
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