Kardiologie up2date 2011; 7(4): 295-306
DOI: 10.1055/s-0030-1257063
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© Georg Thieme Verlag KG Stuttgart · New York

Prävention der infektiösen Endokarditis: weniger ist mehr

Jörg  W.  Schröder, Vincent  M.  Brandenburg
Further Information

Publication History

Publication Date:
09 February 2012 (online)

Abstract

Infectious endocarditis is a devastating condition due to high morbidity and high mortality. For several decades it was general practice to apply antibiotics as primary and secondary prophylaxis to many candidates also with minor heart disease in the context of various medical procedures. However, wide-spread application of antibiotics has never undergone systematic evidence-providing investigation and moreover, has never proofed to convincingly reduce the incidence of infectious endocarditis. The presumably high rate of spontaneous or „every-day“ episodes of bacteraemia has not been taken sufficiently into account. Recently, current guidelines paid homage to these unpreventable transient bacteraemia and the overall low-level of evidence in the field and „revolutionized “ infectious endocarditis preventive strategies. Application of antibiotics for infectious endocarditis prevention should nowadays be limited to patients most significantly at risk for severe endocarditis with poor outcome. We intend to give an overview upon guideline development over the last decades and present state-of-the art infectious endocarditis preventive strategies based on current national and international guideline publications.

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Dr. med. Jörg Schröder

Universitätsklinikum der RWTH Aachen
Medizinische Klinik I
Klinik für Kardiologie

Pauwelsstr. 30
52074 Aachen

Phone: 0241/ 80–89301

Email: [email protected]