Infective endocarditis: Updated guidelines.

Canadian Paediatric Society, Infectious Diseases and Immunization Committee.
The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale / AMMI Canada (Impact Factor: 0.49). 01/2010; 21(2):74-7.
Source: PubMed

ABSTRACT The most recent revision of the American Heart Association guidelines on infective endocarditis prophylaxis occurred in 2007. These revisions were based on the fact that current data have brought into question the benefit of previous recommendations for infective endocarditis prophylaxis. It was noted that the bacteremia that occurs following dental procedures represents only a fraction of the episodes of bacteremia that occur with activities of daily living (such as chewing, brushing teeth and other oral hygiene measures). The target groups and the procedures for which prophylaxis is reasonable have been significantly reduced in number. The focus is now on patients who are most likely to have adverse outcomes from infectious endocarditis. The present article is targeted at practicing Canadian physicians and provides the rationale for the current recommendations. In addition to a summary of the indications for prophylaxis, information is provided on the conditions for which prophylaxis is not recommended.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Methicillin resistant Staphylococcus aureus (MRSA) septicemia is associated with high morbidity and mortality especially in patients with immunosuppression, diabetes, renal disease and endocarditis. There has been an increase in implantation of cardiac implantable electronic devices (CIED) with more cases of device-lead associated endocarditis been seen. A high index of suspicion is required to ensure patient outcomes are optimized. The excimer laser has been very efficient in helping to ensure successful lead extractions in patients with CIED infections. We present an unusual case report and literature review of MRSA septicemia from device-lead endocarditis and the importance of early recognition and prompt treatment.
    World Journal of Cardiology (WJC) 07/2012; 4(7):231-3. DOI:10.4330/wjc.v4.i7.231 · 2.06 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The use of prophylactic antibiotics for the prevention of infective endocarditis following dental procedures has long been debated and there is still confusion regarding its efficacy. As a result, the prophylactic treatment varies considerably amongst different countries across the world and amongst different dental practitioners. To evaluate the knowledge of dental staff regarding the guidelines for the prevention of infective endocarditis. This was a cross sectional analytical study which included all staff members. A self administered questionnaire was used and responses were "graded" according to the American Heart Association (AHA) guidelines. The response rate was 87% (N=39) and 97% reported to use the AHA guidelines; 66% reported their knowledge was based on previous training and scientific journals. Of those cardiac conditions and dental procedures which required prophylaxis; 47% and 65% chose the correct option, respectively. Penicillin was prescribed as the drug of choice by the majority of respondents. Although almost all staff reported the use of the AHA guidelines, many were not following them. The study emphasizes the need for continuous education and evaluation of this critical aspect of dentistry.
    The Open Dentistry Journal 07/2013; 7:82-7. DOI:10.2174/1874210601307010082
  • [Show abstract] [Hide abstract]
    ABSTRACT: The concept of prophylaxis of infective endocarditis has changed substantially in recent years; currently, prophylaxis is recommended only in patients at highest risk of developing infective endocarditis who are scheduled for dental procedures involving the gingiva. The risk is also increased in individuals with pacemakers and implantable cardioverter/defibrillators. Other high-risk populations include polymorbid patients (diabetes mellitus or chronic hemodialysis), the elderly (particularly those aged 75–79 years), and males. In indicated cases, the drugs used in prevention include amoxycillin or ampicillin.
    Cor et vasa 12/2013; 55(6):e520–e524. DOI:10.1016/j.crvasa.2013.05.006
Show more


Available from