Recommendations on prophylaxis for infective endocarditis: dramatic changes over the past seven years.

Recommendations on antibiotic prophylaxis against infective endocarditis have changed dramatically since 2002. In 2002, the French were the first to make a profound change: they proposed that antibiotic prophylaxis should be optional when a medical, surgical or dental procedure that carries a risk of infective endocarditis was performed in a patient at risk but not at very high risk of infective endocarditis (group B: native valve disease, non-cyanotic congenital heart disease, obstructive hypertrophic cardiomyopathy). In 2004, the European Society of Cardiology and the British Society of Cardiology made almost no changes to their previous recommendations.

[Infective endocarditis].

Infective endocarditis is a severe disease. This fact justifies prophylaxis, although its indications have been narrowed over the last years; as early the diagnosis as possible, that forbids any antibiotic treatment without previous blood cultures in a patient with a cardiac disease at risk for infective endocarditis; often cardiac surgery, whose indications remain difficult and need the collaboration of the cardiologist, the infectious diseases specialist and the cardiac surgeon.