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Antimicrobial prophylaxis for endocarditis: Letter to the Editor (1)
The Cardiothoracic Centre, Liverpool, UK
Correspondence to:
Correspondence to:
Mr J A C Chalmers
The Cardiothoracic Centre, Thomas Drive, Liverpool L14 3PE, UK; john.chalmers@ctc.nhs.uk
| The first 150 words of the full text of this article appear below. |
To the Editor: The title of the editorial by Ashrafian and Bogle1 was clear enough, but the editorial was not.
The representative cardiological bodies in UK, USA and Europe have all published guidelines on the prevention of infective endocarditis (IE). Their guidance is clear. The guidance from the British Society for Antimicrobial Chemotherapy2 on the other hand carries with it a feeling of self-righteousness, but its position is not rational.
The science of endocarditis is clear enough—valves become infected secondary to bacteraemia. The argument that rabbit models do not replicate strictly the pathogenesis of endocarditis in humans2 and that as such the evidence is questionable confines much of the progress made in the 20th century to the intellectual dustbin. The incidence of endocarditis will depend on the organism type, the immune status of the patient and the bacteriological load. The risk of antibiotic-related death from penicillin anaphylaxis (quoted in the
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Heart 2007 93: 902.[Extract] [Full Text] [PDF]
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