PREVENTION OF BACTERIAL ENDOCARDITIS

Key words: Endocarditis, Prophylaxis

Guidelines for prevention of bacterial endocarditis have been recently revised by the American Heart Association and approved by the American Academy of Pediatrics. The revised guidelines aim at simplifying both eligibility criteria and antibiotic regimens. A cost-benefit analysis should be made for each patient taking into account the risk of bacteremia associated with various procedures and the risk of adverse reactions to drugs. High and moderate risk patients are identified on the basis of the type of cardiac anomaly. Different antibiotic prophylaxis regimens are proposed: amoxycillin is suggested to moderate risk patients for low risk procedures and ampicillin plus gentamicin to high risk patients undergoing high risk procedures. Different options are proposed for patients with allergy to penicillin.