Prevention of bacterial endocarditis: recommendations by the American Heart Association

Article Abstract:

Mucosal surfaces and infected tissues treated by surgical or dental procedures release bacteria into the blood for a limited amount of time. The bacteria may lodge in areas of the heart, such as abnormal valves with uneven surfaces (caused by congenital defects or prior surgery). The ensuing infection and inflammation of the membrane lining the heart and its structures is referred to as endocarditis. Because it is not possible to predict the occurrence this infection in vulnerable patients, prophylactic doses of antibiotics (to prevent endocarditis) are usually recommended one hour before and six hours after particular dental and surgical procedures. This article presents an update of the 1984 general guidelines for prophylaxis against endocarditis. Practitioners should be watchful for signs of endocarditis even when antibiotics are given. In high-risk patients, poor dental hygiene may result in bacteremia (bacteria in the blood) even without dental procedures. Therefore, preventive endocarditis therapy should include proper daily dental hygiene. The standard antibiotic regimens for dental, oral, and upper respiratory tract procedures are described; alternative regimens are presented for patients who are allergic to penicillin or unable to take medications by mouth. Treatment regimens to be used during genitourinary and gastrointestinal procedures are discussed. Specific protocols are listed for patients with rheumatic fever or kidney disease, those who are being treated with anticoagulants (anticlotting agents), and patients undergoing heart surgery, including transplantation. ..NM: (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Evaluation, Prevention, Risk factors, Preventive medicine, Medical protocols, Medicine, Preventive

---

Antimicrobial treatment of infective endocarditis due to viridans streptococci, enterococci, and staphylococci

Article Abstract:

Infective endocarditis is caused by a microorganism infecting the lining of the heart. At particular risk are heart valves, including prosthetic heart valves. Similar difficulties can also arise within arteries, particularly where foreign materials have been used to surgically repair them, creating infective endarteritis. The course of these diseases is largely dependent on the virulence of the microorganism underlying them. Clinical symptoms can include fever, heart murmurs, heart problems and enlargement of the spleen. Before the advent of antibiotics, the outcome was invariably fatal. The organisms most often involved are the round or cocci bacteria that are known as Gram-positive cocci because they stain with Gram stain. Gram-positive cocci include viridans streptococci, enterococci, and staphylococci. Drugs that may be used include penicillan or vancomycin for penicillin-allergic patients. All patients with infective endocarditis should be followed-up with blood cultures once or twice in the eight weeks following an antibacterial treatment. Relapses, if they occur, usually do so within the first month after treatment. Surgery should be considered for patients with a prosthetic valve if they fail to respond to treatment. The major cause of death in infective endocarditis is valve failure and subsequent congestive heart failure.

Dosage and administration

---

Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci, and HACEK microorganisms

Article Abstract:

Guidelines for the antibiotic treatment of infective endocarditis are provided. Endocarditis is a disease of inflammatory alterations in the endothelial lining membrane of the heart cavities and in the connective tissue bed. The recommendations were compiled using published studies and the experience of experts in treating endocarditis caused by microorganisms, including viridans streptococci, enterococci, S. bovis, staphylococci, and bacilli of the HACEK group. Patients with infective endocarditis should be followed closely for completion of antibiotic treatment. Treatment of enterococcal endocarditis is difficult because the organisms are resistant to penicillin. However, the use of ampicillin, penicillin or vancomycin with aminoglycoside antibiotics may be effective. The therapy should continue for four weeks.

Health aspects

Similar abstracts:

• Abstracts: Prevention of bacterial endocarditis: recommendations by the American Heart Association. Subacute bacterial endocarditis: considerations for the pediatric patient
• Abstracts: Limited evolution of HIV antiretroviral drug resistance-associated mutations during the performance of drug resistanse testing
• Abstracts: Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection. Cocaine use and HIV infection in intravenous drug users in San Francisco
• Abstracts: Transmission of retroviruses by transfusion of screened blood in patients undergoing cardiac surgery. Changes in T-lymphocyte subsets in intravenous drug users with HIV-1 infection
• Abstracts: Listeriosis. Role of foods in sporadic listeriosis: I. case-control study of dietary risk factors. Role of foods in sporadic listeriosis: II. microbiologic and epidemiologic investigation

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.