A decade of research has led to more precise guidelines for a complex health problem
It has long been considered that all patients with heart conditions that predispose to infective endocarditis should receive antibiotic prophylaxis when undergoing procedures that can lead to bacteraemia with organisms known to cause endocarditis. However, the evidence for such action is surprisingly poor.1 It is based on isolated case reports of endocarditis following dental or other procedures, and on theoretical considerations, rather than the results of randomised controlled trials.
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- 1 Fiji School of Medicine, Suva, Fiji.
- 2 Therapeutic Guidelines Limited, Melbourne, VIC.
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- 2. Antibiotic Expert Group. Therapeutic guidelines: antibiotic. Version 13. Melbourne: Therapeutic Guidelines Limited, 2006.
- 3. Roberts GJ. Dentists are innocent! “Everyday” bacteremia is the real culprit: a review and assessment of the evidence that dental surgical procedures are a principal cause of bacterial endocarditis in children. Pediatr Cardiol 1999; 20: 317-325.
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- 8. National Institute for Health and Clinical Excellence. Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditits in adults and children undergoing interventional procedures. London: NICE, 2008. http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11938 (accessed Aug 2008).