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36.11 Antibiotic prophylaxis and prevention of infective endocarditis
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Published:July 2018
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Abstract
Prevention of infective endocarditis has historically focused on oral health because oral streptococci are part of oral flora and once caused most cases of native valve infective endocarditis. Because no randomized clinical trial has ever been conducted to confirm the efficacy and safety of antibiotic prophylaxis of infective endocarditis, it is likely that the debate on indications for antibiotic prophylaxis of infective endocarditis will continue in the coming years. In the meantime, it is reasonable to propose antibiotic prophylaxis to patients at high risk of infective endocarditis before they undergo high-risk dental procedures. Prevention of healthcare-associated infective endocarditis should also be targeted through prevention of healthcare-acquired bacteraemia, and antibiotic prophylaxis before the implantation of cardiac implantable electronic devices. Other prevention options include preservation of good oral hygiene. In the future, prevention of Staphylococcus aureus endocarditis might rely on vaccines, with candidate S. aureus vaccines currently being evaluated in humans.
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