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Time to Move Forward

Todd B. Seto, MD, MPH

Arch Intern Med. 2007;167(4):327-330.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

The concept of using antibacterial agents to prevent infectious endocarditis (IE) was proposed more than 60 years ago¹ and was first endorsed by the American Heart Association (AHA) in its recommendations for IE prophylaxis published in 1955.² Since that time, IE prophylaxis has become a widely accepted preventive measure, broadly endorsed by a number of international professional societies, representing cardiologists, gastroenterologists, infectious diseases specialists, dentists, and pediatricians.²

Like other rare illnesses, IE is difficult to study, and firm evidence establishing the benefit of prophylaxis has been elusive. Indeed, studies suggesting that IE prophylaxis is ineffective^3-6 and carries a risk of adverse drug events,⁷ and increased bacterial resistance⁸ has prompted calls to revise the AHA recommendations and scale back its use.⁹ However, IE prophylaxis has become engrained in the minds of physicians, dentists, and their patients, and, although not its intent, the AHA recommendations for IE . . . [Full Text of this Article]

HIGH MORBIDITY AND MORTALITY OF IE

WE CAN IDENTIFY PATIENTS AT RISK FOR IE

WE CAN IDENTIFY HIGH-RISK PROCEDURES

ANTIBIOTICS DECREASE BACTEREMIA AND PREVENT IE

CONCLUSIONS

AUTHOR INFORMATION

Author Affiliations: Center for Outcomes Research and Evaluation, The Queen's Medical Center, and Division of Cardiology, Department of Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii.

RELATED ARTICLE

Rebuttal
Andrew Mark Morris
Arch Intern Med. 2007;167(4):333-334.
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