AHA 2018 | Endocarditis Prophylaxis More Limited after AHA 2007 Guidelines

The incidence of infective endocarditis had decreased after AHA 2007 recommendations. At present, some patients are not receiving antibiotic prophylaxis as they should.

Disminuye la profilaxis de endocarditis luego de las guías del 2007After AHA restricted the use of antibiotic prophylaxis in 2007, high-risk patients undergoing dental procedures were prescribed less antibiotics. These patients had always been prescribed antibiotic prophylaxis, regardless they had less restrictive guidelines.  

 

At the same time, we observe a surprising trend towards lower incidence of infections endocarditis, which calls our attention. All these cases were presented at AHA annual meeting in 2018, and simultaneously published in JACC.


Read also: AHA 2018 | Freedom Long-Term Follow-up: Still in Favor of CABG.


In moderate risk patients, there was a more appropriate reduction of antibiotic prophylaxis after the new recommendations, with a more modest reduction in endocarditis rate for this group.

 

Even though this is an observational study, and we are no table to establish a cause-effect relationship between prescription frequency and endocarditis incidence, these finding support guideline recommendations.

 

However, we should not drop our guard: all high-risk patients undergoing dental procedures should receive antibiotic prophylaxis (not those at moderate risk).

 

Researchers estimate antibiotic prophylaxis has fallen across all groups since 2007 AHA recommendations. The drop has affected 52% of low or unknown risk patients, 64% of patients at moderate risk and 20% of high-risk patients.

 

Original title: Antibiotic prophylaxis and incidence of endocarditis before and after the 2007 AHA recommendations.

Reference: Thornhill et al. J Am Coll Cardiol. 2018;72:2543-2554.

 

profilaxis-antibiótica


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....