Prävention der infektiösen Endokarditis: weniger ist mehr

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.

Literatur

• 1 Westphal N, Plicht B, Naber C. Infective endocarditis-prophylaxis, diagnostic criteria, and treatment.  Dtsch Arztebl Int. 2009;  106 (28–29) 481-489
• 2 Prendergast B D. The changing face of infective endocarditis.  Heart. 2006;  92 (7) 879-885
• 3 Hoen B, Alla F, Selton-Suty C et al. Changing profile of infective endocarditis: results of a 1-year survey in France.  JAMA. 2002;  288 (1) 75-81
• 4 Habib G, Hoen B, Tornos P et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer.  Eur Heart J. 2009;  30 (19) 2369-2413
• 5 Que Y A, Moreillon P. Infective endocarditis.  Nat Rev Cardiol. 2011;  8 (6) 322-336
• 6 Pallasch T J. Antibiotic prophylaxis: problems in paradise.  Dent Clin North Am. 2003;  47 (4) 665-679
• 7 Wilson W, Taubert K A, Gewitz 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 (15) 1736-1754
• 8 Naber , Al-Nawas B, Baumgartner H et al. Prophylaxe der infektiösen Endokarditis.  Kardiologe. 2007;  1 243-250
• 9 Osler W. The Gulstonian Lectures, on Malignant Endocarditis.  Br Med J. 1885;  1 (1264) 577-579
• 10 Osler W. The Gulstonian Lectures, on Malignant Endocarditis.  Br Med J. 1885;  1 (1263) 522-526
• 11 Osler W. The Gulstonian Lectures, on Malignant Endocarditis.  Br Med J. 1885;  1 (1262) 467-470
• 12 Abbott M. Congenital cardiac disease.. In: Osler W, McCrae T, (eds). Modern Medicine: Its Theory and Practice.. 2011: 425
• 13 Hirsh H L, Vivino J J. Effect of prophylactically administered penicillin on incidence of bacteremia following extraction of teeth; results in patients with healed rheumatic and bacterial endocarditis.  Arch Intern Med (Chic). 1948;  81 (6) 868-878
• 14 Bloomfield A L. Diagnosis and prevention of bacterial endocarditis.  Circulation. 1953;  8 (2) 290-296
• 15 Rammelkamp C H, Breese B B, Griffeath H I et al. Prevention of rheumatic fever and bacterial endocarditis through control of streptococcal infections.  Circulation. 1957;  15 154-158
• 16 Dajani A S, Taubert K A, Wilson W et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association.  Circulation. 1997;  96 (1) 358-366
• 17 Roberts G J. Dentists are innocent! „Everyday“ bacteremia is the real culprit: a review and assessment of the evidence that dental surgical procedures are a principal cause of bacterial endocarditis in children.  Pediatr Cardiol. 1999;  20 (5) 317-325
• 18 Selton-Suty C, Duval X, Brochet E et al. New French recommendations for the prophylaxis of infectious endocarditis.  Arch Mal Coeur Vaiss. 2004;  97 (6) 626-631
• 19 Lin R Y. A perspective on penicillin allergy.  Arch Intern Med. 1992;  152 (5) 930-937
• 20 Oliver R, Roberts G J, Hooper L, Worthington H V. Antibiotics for the prophylaxis of bacterial endocarditis in dentistry.  Cochrane Database Syst Rev. 2008;  4 CD003813
• 21 Glauser M P, Bernard J P, Moreillon P, Francioli P. Successful single-dose amoxicillin prophylaxis against experimental streptococcal endocarditis: evidence for two mechanisms of protection.  J Infect Dis. 1983;  1473 568-575
• 22 Nishimura R A, Carabello B A, Faxon D P et al. ACC/AHA 2008 guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.  Circulation. 2008;  1188 887-896
• 23 Murdoch D R, Corey G R, Hoen B et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.  Arch Intern Med. 2009;  1695 463-473
• 24 Forner L, Larsen T, Kilian M, Holmstrup P. Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation.  J Clin Periodontol. 2006;  336 401-407
• 25 Fisher M A, Borgnakke W S, Taylor G W. Periodontal disease as a risk marker in coronary heart disease and chronic kidney disease.  Curr Opin Nephrol Hypertens. 2010;  196 519-526