[Prevention of bacterial endocarditis: current recommendations].
International consensus has been reached on the guidelines of prevention programmes of bacterial endocarditis in patients bearing a valvulopathy and submitted to various diagnostic or surgical procedures. They are presently characterised by: 1) targeting of indications: less procedures have to be covered by an appropriate antibiotic and owing to progresses made in ultrasonography, less patients with mitral valve prolapse have to be protected; 2) simplification of the administration of the antibiotics: priority is given to the oral route and two doses are sufficient, one before, and one after the procedure; 3) the dropping of penicillin V and the questioning of erythromycin: amoxicillin becomes the first-choice drug, more often administered orally than parenterally; in case of allergy to beta-lactams, clindamycin takes precedence over macrolides. Those new strategies for antibiotic prophylaxis should reveal themselves better followed, more performant and less expensive.
Sternon
J
J
Services de Médecine interne et de Bactériologie, Hôpital Erasme, Bruxelles.
Serruys
E
E
D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D002981:Clindamycin / Q000008:administration & dosage; D004697:Endocarditis, Bacterial / Q000517:prevention & control*; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D011292:Premedication; D012307:Risk Factors; D013514:Surgical Procedures, Operative
D002981:Clindamycin; D000658:Amoxicillin
Prévention de l'endocardite bactérienne: nouvelles recommandations.