Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 2/2017

Open Access 01-02-2017 | Cardiovascular Infections (B Hoen, Section Editor)

Antibiotic Prophylaxis of Infective Endocarditis

Authors: Martin H. Thornhill, Mark Dayer, Peter B. Lockhart, Bernard Prendergast

Published in: Current Infectious Disease Reports | Issue 2/2017

Login to get access

Abstract

Links between infective endocarditis (IE) and dental and other invasive procedures were first identified in the 1920s, and the use of antibiotic prophylaxis (AP) to prevent IE was first recommended by the American Heart Association in 1955. Recognising the weak evidence to support this practice and the wider risks of anaphylaxis and antibiotic resistance, guidelines in the USA and Europe have been rationalised in the last decade with restriction of AP to those patients perceived to be at the highest risk. In the UK, the National Institute for Health and Care Excellence controversially recommended the complete cessation of AP for all invasive procedures in 2008 and subsequent epidemiological studies have suggested a significant increase in cases above the baseline trend. AP appears to be safe and is likely to be cost-effective. Until further data are available, we recommend continued adherence to US and European guidelines.
Literature
1.
2.
3.
Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler Jr VG, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169:463–73.CrossRefPubMedPubMedCentral
4.
Winge E. Endocraditis (Mycosis endocardii). Nord Med Ark. 1870;14:15–6.
5.
Klebs E. Weitere Beitrage zur Enststehungsgeschichte der endocarditis. Arch Exp Pathol Pharmakol. 1878;9:52.CrossRef
6.
Rosenbach O. Ueber artificielle Herzklappenfehler. Arch Exp Pathol Pharmakol. 1878;9:1–30.CrossRef
7.
Wyssokowitsch V. Beitrage zur Lehre von der Endocraditis. Arch Pathol Anat Phys. 1886;103:301–32.CrossRef
8.
9.
10.
11.
Lewis T, Grant R. Observations relating to subacute infective endocarditis. Heart. 1923;10:21–77.
12.
Okell CC, Elliott SD. Bacteraemia and oral sepsis: with special reference to the aetiologu of subacute endocarditis. Lancet. 1935;226:869–72.CrossRef
13.
Billings F. Mouth infection as a source of systemic disease. JAMA. 1914;LXIII:899–903.CrossRef
14.
Billings F. The principles involved in focal infection as related to systemic disease. JAMA. 1916;LXVii:847–50.CrossRef
15.
Focal infection. J Am Med Assoc. 1952;150:490–1.
16.
Reimann HA, Havens WP. Focal infection and systematic disease: a critical appraisal. The case against indiscriminate removal of teeth and tonsils. JAMA. 1940;114:1–6.
17.
Hupp JR. Changing methods of preventing infective endocarditis following dental procedures: 1943 to 1993. J Oral Maxillofac Surg. 1993;51:616–23.CrossRefPubMed
18.
Kolmer JA, Tuft L. Clinical immunology, biotherapy and chemotherapy. Philadelphia: WB Saunders Co; 1941.
19.
Long PH, Bliss E. Clinical use of sulfanilamide, sulfapyridine and allied compounds. New York: MacMillan Co; 1939.
20.
Hirsch HL, Vivino JJ, Merril A, Dowling HF. Effect of prophylactically administered penicillin on incidence of bacteremia following extraction of teeth. Arch Intern Med. 1948;81:868–78.CrossRef
21.
Jones TD, Baumgartner L, Bellows MT, Breese BB, Kuttner AG, McCarty M, et al. Prevention of rheumatic fever and bacterial endocarditis through control of streptococcal infections. Circulation. 1955;11:317–20.
22.
American Heart Association. Prevention of rheumatic fever and bacterial endocarditis through control of streptococcal infections. Circulation. 1960;21:151–5.CrossRef
23.
American Heart Association Committee on Prevention of Rheumatic Fever and Bacterial Endocarditis. Prevention of bacterial endocarditis. Circulation. 1965;31:953–4.CrossRef
24.
American Heart Association. Prevention of bacterial endocarditis. J Am Dent Assoc. 1972;85:1377–9.CrossRef
25.
Kaplan EL, Anthony BF, Bisno A, Drack D, Houser H, Millard DH, et al. Prevention of bacterial endocarditis. Circulation. 1977;56:139A–43.CrossRefPubMed
26.
Carpentier A. The concept of bioprosthesis. Thoraxchir Vask Chir. 1971;19:379–83.PubMed
27.
Harken DE, Taylor WJ, Lefemine AA, Lunzer S, Low HB, Cohen ML, et al. Aortic valve replacement with a caged ball valve. Am J Cardiol. 1962;9:292–9.CrossRefPubMed
28.
29.
30.
Report of a working party of the British Society for Antimicrobial Chemotherapy The antibiotic prophylaxis of infective endocarditis. Lancet. 1982;2:1323–6.
31.
Brooks SL. Survey of compliance with American Heart Association guidelines for prevention of bacterial endocarditis. J Am Dent Assoc. 1980;101:41–3.CrossRefPubMed
32.
Leport C, Horstkotte D, Burckhardt D, Suppl B. Antibiotic prophylaxis for infective endocarditis from an international group of experts towards a European consensus. Group of Experts of the International Society for Chemotherapy. Eur Heart J. 1995;16:126–31.CrossRefPubMed
33.
Dajani AS, Taubert KA, Wilson W, Bolger AF, Bayer A, Ferrieri P, et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. Circulation. 1997;96:358–66.CrossRefPubMed
34.
Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, et al. Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary; the task force on infective endocarditis of the European society of cardiology. Eur Heart J. 2004;25:267–76.CrossRefPubMed
35.
Gould FK, Elliott TS, Foweraker J, Fulford M, Perry JD, Roberts GJ, et al. Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 2006;57:1035–42.CrossRefPubMed
36.
Antibiotics for the prophylaxis of bacterial endocarditis in dentistry. [Review][Update of Cochrane Database Syst Rev. 2008;(4):CD003813; PMID: 18843649] Glenny AM; Oliver R; Roberts GJ; Hooper L; Worthington HV.
37.
38.
Ramsdale DR, Morrison L, Palmer MD, Fabri B. Lethal consequences. Br Dent J. 2006;201:187. author reply 188.CrossRefPubMed
39.
40.
Dayer MJ, Chambers JB, Prendergast B, Sandoe JA, Thornhill MH. NICE guidance on antibiotic prophylaxis to prevent infective endocarditis: a survey of clinicians’ attitudes. QJM. 2013;106:237–43.CrossRefPubMed
41.
Thornhill MH, Dayer MJ, Forde JM, Corey GR, Chu VH, Couper DJ, et al. Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study. BMJ. 2011;342:d2392.CrossRefPubMedPubMedCentral
42.
National Institute for Health and Care Excellence (NICE). Prophylaxis against infective endocarditis—Appendix 6. de novo economic analysis. Secondary prophylaxis against infective endocarditis—Appendix 6. de novo economic analysis. 2008;Volume:Pages.http://​www.​nice.​org.​uk/​CG064. Accessed March 2008
43.
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116:1736–54.CrossRefPubMed
44.
Thornhill MH, Lockhart PB, Prendergast B, Chambers JB, Shanson D. NICE and antibiotic prophylaxis to prevent endocarditis. Br Dent J. 2015;218:619–21.CrossRefPubMed
45.
Duval X, Delahaye F, Alla F, Tattevin P, Obadia JF, Le Moing V, et al. Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys. J Am Coll Cardiol. 2012;59:1968–76.CrossRefPubMed
46.
47.
Rogers AM, Schiller NB. Impact of the first nine months of revised infective endocarditis prophylaxis guidelines at a university hospital: so far so good. J Am Soc Echocardiogr. 2008;21:775.CrossRefPubMed
48.
Desimone DC, Tleyjeh IM, de Sa DD C, Anavekar NS, Lahr BD, Sohail MR, et al. Incidence of infective endocarditis caused by viridans group streptococci before and after publication of the 2007 American Heart Association’s endocarditis prevention guidelines. Circulation. 2012;126:60–4.CrossRefPubMedPubMedCentral
49.
Dayer M, Thornhill M. Antibiotic prophylaxis guidelines and infective endocarditis: cause for concern? J Am Coll Cardiol. 2015;65:2077–8.CrossRefPubMed
50.
Pant S, Patel NJ, Deshmukh A, Golwala H, Patel N, Badheka A, et al. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015;65:2070–6.CrossRefPubMed
51.
Pasquali SK, He X, Mohamad Z, McCrindle BW, Newburger JW, Li JS, et al. Trends in endocarditis hospitalizations at US children’s hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines. Am Heart J. 2012;163:894–9.CrossRefPubMedPubMedCentral
52.
Bikdeli B, Wang Y, Kim N, Desai MM, Quagliarello V, Krumholz HM. Trends in hospitalization rates and outcomes of endocarditis among Medicare beneficiaries. J Am Coll Cardiol. 2013;62:2217–26.CrossRefPubMedPubMedCentral
53.••
Mackie AS, Liu W, Savu A, Marelli AJ and Kaul P. Infective endocarditis hospitalizations before and after the 2007 American Heart Association Prophylaxis Guidelines. Can J Cardiol. 2016; 32(8):942-8. The largest observational study to date, using Canadian national data to characterise the impact of the 2007 AHA guideline restricting antibiotic prophylaxis to prevent infective endocarditis to those at the highest risk (see also the related correspondence, references 54 and 55).
54.
Mackie AS, Liu W, Savu A, Marelli AJ and Kaul P. Reply to Letter From Thornhill et al.-Infective endocarditis hospitalizations before and after the 2007 American Heart Association Prophylaxis Guidelines. Can J Cardiol. 2016; 32(12):1578.e11.
55.
Thornhill MH, Dayer MJ, Jones S, Prendergast B, Baddour LM and Lockhart PB. The effect of antibiotic prophylaxis guidelines on incidence of infective endocarditis. Can J Cardiol. 2016; 32(12):1578.e9.
56.
Chambers JB, Shanson D, Hall R, Pepper J, Venn G, McGurk M. Antibiotic prophylaxis of endocarditis: the rest of the world and NICE. J R Soc Med. 2011;104:138–40.CrossRefPubMedPubMedCentral
57.
Chambers JB, Shanson D, Venn G, Pepper J. NICE v world on endocarditis prophylaxis. BMJ. 2011;342:d3531.CrossRefPubMed
58.••
Dayer MJ, Jones S, Prendergast B, Baddour LM, Lockhart PB, Thornhill MH. Incidence of infective endocarditis in England, 2000–13: a secular trend, interrupted time-series analysis. Lancet. 2015;385:1219–28. This observational study of English national data is the only study to-date to evaluate the impact of the NICE recommendation to stop using antibiotic prophylaxis (AP) to prevent infective endocarditis (IE) altogether. It is also the only study to have looked at the impact of guideline change on both AP prescribing and incidence of IE. It found a highly significant fall in AP prescribing and a significant increase in incidence of IE (reference 41 is an earlier evaluation of the same data by the same group but with a shorter post guideline change follow-up period).CrossRefPubMed
59.•
60.••
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36:3075–128. This important paper represents the outcome of a major review of the prevention, diagnosis and management of infective endocarditis by the guideline committee of the European Society for Cardiology. It represents the most up-to-date international guidance on antibiotic prophylaxis to prevent invective endocarditis.CrossRefPubMed
61.•
Thornhill MH, Dayer M, Lockhart PB, McGurk M, Shanson D, Prendergast B, et al. A change in the NICE guidelines on antibiotic prophylaxis. Br Dent J. 2016;221:112–4. This paper was the first to bring attention to a very significant change in the wording of the NICE guidelines on antibiotic prophylaxis (AP) to prevent infective endocarditis (IE). The wording change replaced the absolute recommendation not to give AP with a recognition that are some individual circumstances where AP prior to invasive dental procedures may be appropriate.CrossRefPubMed
62.
Thornhill MH, Dayer M, Lockhart PB, McGurk M, Shanson D, Prendergast B, et al. Guidelines on prophylaxis to prevent endocarditis. Br Dent J. 2016;220:51–6.CrossRefPubMed
63.••
Thornhill MH, Dayer MJ, Prendergast B, Baddour LM, Jones S, Lockhart PB. Incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis. J Antimicrob Chemother. 2015;70:2382–8. This is the only paper to have looked specifically at the risk of adverse drug reactions with antibiotic prophylaxis (AP) regimens used to prevent infective endocarditis. It was based on English national data and found a very low risk of adverse reactions, and no deaths, associated with the use of amoxicillin AP in those without a history of penicillin allergy. It did, however, identify a significant risk of Clostridium difficile adverse reactions with the use of clindamycin AP.CrossRefPubMedPubMedCentral
64.
Lockhart PB, Blizzard J, Maslow AL, Brennan MT, Sasser H, Carew J. Drug cost implications for antibiotic prophylaxis for dental procedures. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115:345–53.CrossRefPubMed
65.
Clemens JD, Ransohoff DF. A quantitative assessment of pre-dental antibiotic prophylaxis for patients with mitral-valve prolapse. J Chronic Dis. 1984;37:531–44.CrossRefPubMed
66.
Franklin M, Wailoo A, Dayer M, Jones S, Prendergast B, Baddour LM, Lockhart PB and Thornhill MH. The cost-effectiveness of antibiotic prophylaxis for patients at risk of infective endocarditis. Circ. 2016;134:1568–78.
Metadata
Title
Antibiotic Prophylaxis of Infective Endocarditis
Authors
Martin H. Thornhill
Mark Dayer
Peter B. Lockhart
Bernard Prendergast
Publication date
01-02-2017
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 2/2017
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0564-y

Other articles of this Issue 2/2017

Current Infectious Disease Reports 2/2017 Go to the issue

Neurological Infections (J Lyons, Section Editor)

Neurologic Manifestation of Chikungunya Virus

Neurological Infections (J Lyons, Section Editor)

Infectious Complications of Novel Multiple Sclerosis Therapies

Cardiovascular Infections (B Hoen, Section Editor)

Cardiac Imaging of Infective Endocarditis, Echo and Beyond

Neurological Infections (J Lyons, Section Editor)

The Viral Connection to Glioblastoma
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits