Pediatrics in Review
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(Pediatrics in Review. 2008;29:169-170.)
© 2008 American Academy of Pediatrics

Update

Infective Endocarditis Prophylaxis: Reckoning With the Evidence


Michael Silberbach, MD*
 * Editorial Board

The first 20% of the full text of this article appears below.


   Introduction
 
In an effort to offer clinicians reasonable guidelines for the prevention of infective endocarditis (IE), the American Heart Association (AHA) has published a landmark revision of its widely followed statement on prophylaxis. (1) This tenth version since 1955 considerably decreases the number of conditions for which antimicrobial prophylaxis should be administered prior to bacteremia-producing procedures. The guidelines continue to endorse the rationale for prophylaxis: It is better to prevent IE than to treat established cardiovascular infection; specific cardiac diseases are at greater risk for IE; certain dental, gastrointestinal (GI), and genitourinary (GU) procedures typically cause bacteremia that could lead to IE; and at least in animal models, there is evidence that antibiotics can prevent IE. However, in . . . [Full Text of this Article]






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