[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.
Services de Médecine interne et de Bactériologie, Hôpital Erasme, Bruxelles.
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Sternon
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Serruys
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.