title: Management of patients with infective endocarditis by a multidisciplinary team approach: an operative protocol.
abstract: Even in the modern era of advanced diagnostic imaging, improved antibiotic therapy and potentially curative surgery, infective endocarditis remains a serious disease with high rates of morbidity and mortality. Reasons for such a persistently poor outcome may be represented by the changing epidemiology and microbiology, with new groups of patients at risk and new and more aggressive microorganisms. However, the inadequate use of both diagnostic (blood cultures and echocardiography) and therapeutic (antibiotics and surgery) means can influence the generally delayed diagnosis and poor prognosis seen in patients with infective endocarditis. We tried to identify the critical points in the management of patients with infective endocarditis and to elaborate a formal multidisciplinary approach based on the strict collaboration of specialists in infectious diseases, microbiology, cardiology and cardiac surgery. We hypothesized that this approach could increase the adherence to the published guidelines, and could represent a means to improve the outcome of patients with infective endocarditis.
authors.affiliation: Department of Cardiology, Ca' Foncello Hospital, Treviso, Italy. fchirillo@tin.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Chirillo
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Scotton
authors.forename: Francesco
authors.initials: F
authors.lastname: Rocco
authors.forename: Roberto
authors.initials: R
authors.lastname: Rigoli
authors.forename: Elvio
authors.initials: E
authors.lastname: Polesel
authors.forename: Zoran
authors.initials: Z
authors.lastname: Olivari
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002985:Clinical Protocols; D003266:Continuity of Patient Care; D003657:Decision Making; D004452:Echocardiography; D004696:Endocarditis / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D019983:Guideline Adherence; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D010351:Patient Discharge; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D061665:Time-to-Treatment
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein