Prevention of Bacterial Endocarditis

Abstract

Antimicrobial prophylaxis for bacterial endocarditis in select patients has become the standard of medical care in the United States. This practice exists despite the fact that there are no randomized controlled human studies in patients with underlying structural heart disease that definitely establish that antibiotic prophylaxis provides protection against endocarditis during procedures that induce bacteremia. This chapter is based on the recommendations formulated and published by the American Heart Association (AHA) in 1997 (1). When the AHA published the recommendations, it was expressly stated that the document was meant as a guideline and is “not intended as the standard of care or as a substitute for clinical judgment.” The 1997 guidelines represent an update from recommendations published by the AHA in 1990.