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Heart 2007;93:524-527; doi:10.1136/hrt.2004.057794
Copyright © 2007 BMJ Publishing Group Ltd & British Cardiovascular Society

EDUCATION IN HEART

Valve disease

Infective endocarditis: a comparison of international guidelines

Francois Delahaye1, Joyce Wong2, Peter G Mills2

1 Hôpital cardiovasculaire et pneumologique, Lyon, France
2 Department of Cardiology, London Chest Hospital, London, UK

Correspondence to:
Correspondence to:
Professor François Delahaye
Hôpital cardiovasculaire et pneumologique, BP Lyon Montchat, 69394—Lyon Cedex 03, France; francois.delahaye@chu-lyon.fr

Keywords: infective endocarditis; prophylaxis

The first 150 words of the full text of this article appear below.

Infective endocarditis (IE) is an uncommon disorder that carries a significant morbidity and mortality. Despite advances in diagnostic techniques as well as antimicrobial and surgical treatment, escalating antibiotic resistance in IE pathogens and new patterns of disease ensure that the management of IE remains a challenge.

Since 1955, both national and international guidelines have evolved to aid the prophylaxis, diagnosis and treatment of this important disease. However, the nature of IE ensures that the evidence base from which these guidelines have traditionally been derived is limited to case–control cohort studies, animal data and expert consensus opinion. For both practical and ethical reasons, no large, well-designed, randomised controlled trial has been conducted on either prophylaxis or treatment of IE. Despite the absence of a strong evidence base, antibiotic prophylaxis before a range of dental and other surgical procedures in susceptible populations is universally practised in the developed world.

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