FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 332:38-44 January 5, 1995 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Infective endocarditis is always fatal if untreated and continues to cause substantial morbidity and mortality despite modern antimicrobial and surgical treatment.^1,2,3,4,5 Therefore, prevention is a priority. In 1909, Lord Thomas Horder wrote that when "infection is grafted upon a previously sclerosed endocardium . . . it is possible to do something to prevent the mischief. . . . The source of the infecting agent in most of the cases is the mouth or the intestine. . . . Attention might profitably be directed to these regions in all persons known to possess valvular defects."⁶ Today we continue efforts "to do . . . [Full Text of this Article]

The Rationale for Prophylaxis against Endocarditis

The Role of Bacteremia in Pathogenesis

Epidemiologic Features

Incidence

The Risk of Endocarditis Associated with Preexisting Cardiac Disorders

Endocarditis Caused by Dental and Surgical Procedures

Potentially Preventable Cases

Studies of Prophylaxis in Animals

The Mechanism of Prevention

The Relevance of Research Findings to Humans

Clinical Studies of Prophylaxis against Endocarditis

Failure of Prophylaxis

Local Preventive Measures

Cost–Benefit Analyses

Knowledge, Attitudes, and Practice

Medical–Legal Considerations

Current Recommendations

Future Directions

Conclusions

Source Information

From the Department of Medicine, HealthCare International Medical Centre, Beardmore St., Clydebank G81 4DY, Scotland, United Kingdom, where reprint requests should be addressed to Dr. Durack.

References

This article has been cited by other articles:

• Urano-Tashiro, Y., Yajima, A., Takashima, E., Takahashi, Y., Konishi, K. (2008). Binding of the Streptococcus gordonii DL1 Surface Protein Hsa to the Host Cell Membrane Glycoproteins CD11b, CD43, and CD50. Infect. Immun. 76: 4686-4691 [Abstract] [Full Text]  
• Uckay, I., Pittet, D., Bernard, L., Lew, D., Perrier, A., Peter, R. (2008). Antibiotic prophylaxis before invasive dental procedures in patients with arthroplasties of the hip and knee. J Bone Joint Surg Br 90-B: 833-838 [Abstract] [Full Text]  
• Ohara-Nemoto, Y., Haraga, H., Kimura, S., Nemoto, T. K. (2008). Occurrence of staphylococci in the oral cavities of healthy adults and nasal oral trafficking of the bacteria. J Med Microbiol 57: 95-99 [Abstract] [Full Text]  
• Laks, H., Marelli, D., Plunkett, M., Myers, J. (2008). Adult Congenital Heart Disease. Card Surg Adult 3: 1431-1464 [Full Text]  
• Carmona, I. T., Diz Dios, P., Scully, C. (2007). Efficacy of Antibiotic Prophylactic Regimens for the Prevention of Bacterial Endocarditis of Oral Origin. J. Dent. Res. 86: 1142-1159 [Abstract] [Full Text]  
• Wilson, W., Taubert, K. A., Gewitz, M., Lockhart, P. B., Baddour, L. M., Levison, M., Bolger, A., Cabell, C. H., Takahashi, M., Baltimore, R. S., Newburger, J. W., Strom, B. L., Tani, L. Y., Gerber, M., Bonow, R. O., Pallasch, T., Shulman, S. T., Rowley, A. H., Burns, J. C., Ferrieri, P., Gardner, T., Goff, D., Durack, D. T., The Council on Scientific Affairs of the American, (2007). 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 116: 1736-1754 [Abstract] [Full Text]  
• Seto, T. B. (2007). The Case for Infectious Endocarditis Prophylaxis: Time to Move Forward. Arch Intern Med 167: 327-330 [Full Text]  
• Ashrafian, H, Bogle, R G (2007). Antimicrobial prophylaxis for endocarditis: emotion or science?. Heart 93: 5-6 [Abstract] [Full Text]  
• Gould, F. K., Elliott, T. S. J., Foweraker, J., Fulford, M., Perry, J. D., Roberts, G. J., Sandoe, J. A. T., Watkin, R. W. (2006). Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy--authors' response. J Antimicrob Chemother 58: 896-898 [Full Text]  
• Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Page, R. L., Riegel, B. (2006). ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 48: e1-e148 [Full Text]  
• Pocock, S. B., Chen, K. T. (2006). Inappropriate Use of Antibiotic Prophylaxis to Prevent Infective Endocarditis in Obstetric Patients. Obstet Gynecol 108: 280-285 [Abstract] [Full Text]  
• Briggs, G. G., Wan, S. R. (2006). Drug therapy during labor and delivery, part 1.. Am J Health Syst Pharm 63: 1038-1047 [Abstract] [Full Text]  
• Takahashi, Y., Takashima, E., Shimazu, K., Yagishita, H., Aoba, T., Konishi, K. (2006). Contribution of Sialic Acid-Binding Adhesin to Pathogenesis of Experimental Endocarditis Caused by Streptococcus gordonii DL1. Infect. Immun. 74: 740-743 [Abstract] [Full Text]  
• Vriend, J. W.J., Drenthen, W., Pieper, P. G., Roos-Hesselink, J. W., Zwinderman, A. H., van Veldhuisen, D. J., Mulder, B. J.M., on behalf of the ZAHARA investigators, (2005). Outcome of pregnancy in patients after repair of aortic coarctation. Eur Heart J 26: 2173-2178 [Abstract] [Full Text]  
• Ohara-Nemoto, Y., Kishi, K., Satho, M., Tajika, S., Sasaki, M., Namioka, A., Kimura, S. (2005). Infective Endocarditis Caused by Granulicatella elegans Originating in the Oral Cavity. J. Clin. Microbiol. 43: 1405-1407 [Abstract] [Full Text]  
• Kilic, A. O., Tao, L., Zhang, Y., Lei, Y., Khammanivong, A., Herzberg, M. C. (2004). Involvement of Streptococcus gordonii Beta-Glucoside Metabolism Systems in Adhesion, Biofilm Formation, and In Vivo Gene Expression. J. Bacteriol. 186: 4246-4253 [Abstract] [Full Text]  
• Task Force Members, , Horstkotte, D., Follath, F., Gutschik, E., Lengyel, M., Oto, A., Pavie, A., Soler-Soler, J., Thiene, G., von Graevenitz, A., ESC Committee for Practice Guidelines, , Priori, S. G., Alonso Garcia, M. A., Blanc, J.-J., Budaj, A., Cowie, M., Dean, V., Deckers, J., Fernandez Burgos, E., Lekakis, J., Lindahl, B., Mazzotta, G., Morais, J., Oto, A., Smiseth, O. A., Document Reviewers, , Lekakis, J., Vahanian, A., Delahaye, F., Parkhomenko, A., Filipatos, G., Aldershvile, J., Vardas, P. (2004). 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 25: 267-276 [Full Text]  
• Paik, S., Brown, A., Munro, C. L., Cornelissen, C. N., Kitten, T. (2003). The sloABCR Operon of Streptococcus mutans Encodes an Mn and Fe Transport System Required for Endocarditis Virulence and Its Mn-Dependent Repressor. J. Bacteriol. 185: 5967-5975 [Abstract] [Full Text]  
• Stinson, M. W., Alder, S., Kumar, S. (2003). Invasion and Killing of Human Endothelial Cells by Viridans Group Streptococci. Infect. Immun. 71: 2365-2372 [Abstract] [Full Text]  
• Loo, C. Y., Mitrakul, K., Voss, I. B., Hughes, C. V., Ganeshkumar, N. (2003). Involvement of the adc Operon and Manganese Homeostasis in Streptococcus gordonii Biofilm Formation. J. Bacteriol. 185: 2887-2900 [Abstract] [Full Text]  
• Laks, H., Marelli, D., Plunkett, M., Odim, J., Myers, J. (2003). Adult Congenital Heart Disease. Card Surg Adult 2: 1329-1358 [Full Text]  
• Fernandez-Cean, J., Alvarez, A., Burguez, S., Baldovinos, G., Larre-Borges, P., Cha, M. (2002). Infective endocarditis in chronic haemodialysis: two treatment strategies. Nephrol Dial Transplant 17: 2226-2230 [Abstract] [Full Text]  
• Lucas, V. S., Lytra, V., Hassan, T., Tatham, H., Wilson, M., Roberts, G. J. (2002). Comparison of Lysis Filtration and an Automated Blood Culture System (BACTEC) for Detection, Quantification, and Identification of Odontogenic Bacteremia in Children. J. Clin. Microbiol. 40: 3416-3420 [Abstract] [Full Text]  
• Takahashi, Y., Konishi, K., Cisar, J. O., Yoshikawa, M. (2002). Identification and Characterization of hsa, the Gene Encoding the Sialic Acid-Binding Adhesin of Streptococcus gordonii DL1. Infect. Immun. 70: 1209-1218 [Abstract] [Full Text]  
• Kitten, T., Munro, C. L., Wang, A., Macrina, F. L. (2002). Vaccination with FimA from Streptococcus parasanguis Protects Rats from Endocarditis Caused by Other Viridans Streptococci. Infect. Immun. 70: 422-425 [Abstract] [Full Text]  
• Kontoyiannis, D. P., Versalovic, J. (2001). Case 20-2001- A 64-Year-Old Man with Fever and Gram-Negative Bacteremia. NEJM 344: 2009-2014 [Full Text]  
• Froeliger, E. H., Fives-Taylor, P. (2001). Streptococcus parasanguis Fimbria-Associated Adhesin Fap1 Is Required for Biofilm Formation. Infect. Immun. 69: 2512-2519 [Abstract] [Full Text]  
• Mitchell, D. (2001). British Thoracic Society guidelines on diagnostic flexible bronchoscopy. Thorax 56: 1i-21 [Full Text]  
• DELAHAYE, F., DE GEVIGNEY, G. (2001). Should we give antibiotic prophylaxis against infective endocarditis in all cardiac patients, whatever the type of dental treatment?. Heart 85: 9-10 [Full Text]  
• Seto, T. B., Kwiat, D., Taira, D. A., Douglas, P. S., Manning, W. J. (2000). Physicians' Recommendations to Patients for Use of Antibiotic Prophylaxis to Prevent Endocarditis. JAMA 284: 68-71 [Abstract] [Full Text]  
• Tsitsika, A., Pefanis, A., Perdikaris, G. S., Donta, I., Karayiannakos, P., Giamarellou, H. (2000). Single-Oral-Dose Azithromycin Prophylaxis against Experimental Streptococcal or Staphylococcal Aortic Valve Endocarditis. Antimicrob. Agents Chemother. 44: 1754-1756 [Abstract] [Full Text]  
• Loo, C. Y., Corliss, D. A., Ganeshkumar, N. (2000). Streptococcus gordonii Biofilm Formation: Identification of Genes that Code for Biofilm Phenotypes. J. Bacteriol. 182: 1374-1382 [Abstract] [Full Text]  
• Anwari, J. S., Duffy, P., Crosby, E. T. (2000). Epidural Blood Patch (EBP) and septic complication. Canadian J. Anesthesia 47: 289-290 [Full Text]  
• Spirito, P., Rapezzi, C., Bellone, P., Betocchi, S., Autore, C., Conte, M. R., Bezante, G. P., Bruzzi, P. (1999). Infective Endocarditis in Hypertrophic Cardiomyopathy : Prevalence, Incidence, and Indications for Antibiotic Prophylaxis. Circulation 99: 2132-2137 [Abstract] [Full Text]  
• Juarez, Z. E., Stinson, M. W. (1999). An Extracellular Protease of Streptococcus gordonii Hydrolyzes Type IV Collagen and Collagen Analogues. Infect. Immun. 67: 271-278 [Abstract] [Full Text]  
• Meyer, M. W., Gong, K., Herzberg, M. C. (1998). Streptococcus sanguis-Induced Platelet Clotting in Rabbits and Hemodynamic and Cardiopulmonary Consequences. Infect. Immun. 66: 5906-5914 [Abstract] [Full Text]  
• Drangsholt, M. T., Deacon, J. M., Pagliaro, A. J., Zelicof, S. B., Horowitz, H. W. (1998). Correspondence. JBJS 80: 1394-1395 [Full Text]  
• Donohoe, M. T. (1998). Comparing Generalist and Specialty Care: Discrepancies, Deficiencies, and Excesses. Arch Intern Med 158: 1596-1608 [Abstract] [Full Text]  
• Schlesinger, Y., Urbach, J. (1998). Circumcision and Endocarditis Prophylaxis. Arch Pediatr Adolesc Med 152: 412-412 [Full Text]  
• Dajani, A. S., Taubert, K. A., Wilson, W., Bolger, A. F., Bayer, A., Ferrieri, P., Gewitz, M. H., Shulman, S. T., Nouri, S., Newburger, J. W., Hutto, C., Pallasch, T. J., Gage, T. W., Levison, M. E., Peter, G., Zuccaro, G. Jr (1997). Prevention of Bacterial Endocarditis : Recommendations by the American Heart Association. Circulation 96: 358-366 [Abstract] [Full Text]  
• Bohm, J. O., Botha, C. A., Rein, J.-G., Rupp, W. (1997). Endaortitis of Coarctation of the Aorta After Invasive Diagnostics. Ann. Thorac. Surg. 63: 829-830 [Abstract] [Full Text]  
• Terezhalmy, G. T., Safadi, T. J., Longworth, D. L., Muehrcke, D. D. (1997). Oral Disease Burden in Patients Undergoing Prosthetic Heart Valve Implantation. Ann. Thorac. Surg. 63: 402-404 [Abstract] [Full Text]  
• HANSSEN, A. D., OSMON, D. R., NELSON, C. L. (1996). Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Prevention of Deep Periprosthetic Joint Infection*{{dagger}}. JBJS 78: 458-71 [Full Text]