Prevention of infective endocarditis (IE)

2018 ◽  
pp. 127-130
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Infective Endocarditis ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
High Risk Patients ◽  
Operative Site ◽  
Dental Patients ◽  
Risk Patients ◽  
Current Guidelines ◽  
Dental Work

Infective endocarditis is a serious condition due to bacteraemia resulting from interventions. Current guidelines suggested antibiotic prophylaxis should not be used for routine dental or non-dental patients even in high-risk patients. However, it should be considered for high-risk patients for interventional dental work and also in other circumstances if the operative site suspected to be infective and might result in bacteraemia in high-risk patients.

scholarly journals Is extended preoperative antibiotic prophylaxis for high-risk patients necessary before percutaneous nephrolithotomy?

2016 ◽  
Vol 57 (6) ◽  
pp. 417 ◽  
Author(s):  
Aaron M. Potretzke ◽  
Alyssa M. Park ◽  
Tyler M. Bauman ◽  
Jeffrey A. Larson ◽  
Joel M. Vetter ◽  
...  
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Percutaneous Nephrolithotomy ◽  
High Risk Patients ◽  
Preoperative Antibiotic Prophylaxis ◽  
Risk Patients

scholarly journals Antibiotic Prophylaxis for High-Risk Patients With Acute Q Fever: No Definitive Answers Yet

2013 ◽  
Vol 58 (3) ◽  
pp. 446-447 ◽  
Author(s):  
L. M. Kampschreur ◽  
J. J. Oosterheert ◽  
P. C. Wever ◽  
C. P. Bleeker-Rovers
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Q Fever ◽  
High Risk Patients ◽  
Risk Patients ◽  
Acute Q Fever

scholarly journals Extended Antibiotic Prophylaxis May Be Linked to Lower Peri-prosthetic Joint Infection Rates in High-Risk Patients: An Evidence-Based Review

2019 ◽  
Vol 15 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Christopher J. DeFrancesco ◽  
Michael C. Fu ◽  
Cynthia A. Kahlenberg ◽  
Andy O. Miller ◽  
Mathias P. Bostrom
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Evidence Based ◽  
Infection Rates ◽  
High Risk Patients ◽  
Prosthetic Joint ◽  
Risk Patients

scholarly journals Surgically Induced Menopause—A Practical Review of Literature

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 482 ◽  
Author(s):  
Secoșan ◽  
Balint ◽  
Pirtea ◽  
Grigoraș ◽  
Bălulescu ◽  
...  
Keyword(s):  
Decision Making ◽  
High Risk ◽  
Review Of Literature ◽  
Natural Menopause ◽  
High Risk Patients ◽  
Risk Patients ◽  
Similarities And Differences ◽  
Guidelines And Recommendations ◽  
Surgically Induced ◽  
Current Guidelines

Menopause can occur spontaneously (natural menopause) or it can be surgically induced by oophorectomy. The symptoms and complications related to menopause differ from one patient to another. We aimed to review the similarities and differences between natural and surgically induced menopause by analyzing the available data in literature regarding surgically induced menopause and the current guidelines and recommendations, the advantages of bilateral salpingo-oophorectomy in low and high risk patients, the effects of surgically induced menopause and to analyze the factors involved in decision making.

scholarly journals A selective antibiotic prophylaxis policy for laparoscopic cholecystectomy is effective in minimising infective complications

2013 ◽  
Vol 95 (5) ◽  
pp. 345-348 ◽  
Author(s):  
F Yanni ◽  
P Mekhail ◽  
G Morris-Stiff
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Laparoscopic Cholecystectomy ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Gallstone Disease ◽  
Anaerobic Growth ◽  
Current Evidence ◽  
High Risk Patients ◽  
Risk Patients

Introduction It has been demonstrated previously that the identification of bactibilia during cholecystectomy is associated with the presence of one or more risk factors: acute cholecystitis, common duct stones, emergency surgery, intraoperative findings and age >70 years. Current evidence-based guidance on antibiotic prophylaxis during laparoscopic cholecystectomy (LC) is based on elective procedures and does not take into account these factors. The aim of this study was to assess the effectiveness of a selective antibiotic prophylaxis policy limited to high risk patients undergoing LC with the development of port site infections as the primary endpoint. Methods One hundred consecutive patients undergoing LC under the care of a single consultant surgeon during a one-year period were studied prospectively. Data collected included patient demographics (age, sex) as well as details of the history of gallstone disease to determine those with complex disease and risk factors for bactibilia. A single dose of antibiotics (second generation cephalosporin and metronidazole) was administered on induction to patients with a risk factor present. Information relating to all radiologically or microbiologically confirmed infections was documented. Results Eighty-four of the patients were female and the mean age was 47.7 ±16.0 years. Nineteen LCs were performed as emergencies and the remainder were elective procedures. A risk factor for bactibilia was present in 35 patients. A wound infection was identified in four cases, two of which were Staphylococcus aureus (one methicillin resistant), one was a coagulase negative Staphylococcus and one wound cultured a mixed anaerobic growth. Three of the infections occurred in patients receiving prophylaxis (2 staphylococcal and 1 anaerobic) at intervals of 7, 14 and 19 days respectively. One patient with a body mass index of 32kg/m2 in the ‘no prophylaxis’ group developed a coagulase negative staphylococcal infection at 10 days. No intra or extra-abdominal abdominal infections were identified. Conclusions This study has demonstrated that restricting antibiotic prophylaxis to high risk patients has no detrimental effects in terms of increasing the rate of infections in those with no risk factors. Furthermore, the act of not prescribing to low risk patients will limit costs and the risk of adverse events. It will also reduce the risk of resistance and clostridial infections in this cohort.

scholarly journals Epidemiology of infective endocarditis before versus after change of international guidelines: a systematic review

2021 ◽  
Vol 15 ◽  
pp. 175394472110026
Author(s):  
Michael L. Williams ◽  
Mathew P. Doyle ◽  
Nicholas McNamara ◽  
Daniel Tardo ◽  
Manish Mathew ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infective Endocarditis ◽  
High Risk ◽  
North American ◽  
International Guideline ◽  
International Guidelines ◽  
High Risk Patients ◽  
Prescription Rates ◽  
Risk Patients ◽  
Adjusted Incidence

Introduction: All major international guidelines for the management of infective endocarditis (IE) have undergone major revisions, recommending antibiotic prophylaxis (AP) restriction to high-risk patients or foregoing AP completely. We performed a systematic review to investigate the effect of these guideline changes on the global incidence of IE. Methods: Electronic database searches were performed using Ovid Medline, EMBASE and Web of Science. Studies were included if they compared the incidence of IE prior to and following any change in international guideline recommendations. Relevant studies fulfilling the predefined search criteria were categorized according to their inclusion of either adult or pediatric patients. Incidence of IE, causative microorganisms and AP prescription rates were compared following international guideline updates. Results: Sixteen studies were included, reporting over 1.3 million cases of IE. The crude incidence of IE following guideline updates has increased globally. Adjusted incidence increased in one study after European guideline updates, while North American rates did not increase. Cases of IE with a causative pathogen identified ranged from 62% to 91%. Rates of streptococcal IE varied across adult and pediatric populations, while the relative proportion of staphylococcal IE increased (range pre-guidelines 16–24.8%, range post-guidelines 26–43%). AP prescription trends were reduced in both moderate and high-risk patients following guideline updates. Discussion: The restriction of AP to only high-risk patients has not resulted in an increase in the incidence of streptococcal IE in North American populations. The evidence of the impact of AP restriction on IE incidence is still unclear for other populations. Future population-based studies with adjusted incidence of IE, AP prescription rates and accurate pathogen identification are required to delineate findings further in these other regions.

scholarly journals Surgical treatment of valve endocarditis in high-risk patients and predictors of long-term outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Nasso ◽  
Giuseppe Santarpino ◽  
Marco Moscarelli ◽  
Ignazio Condello ◽  
Angelo Maria Dell’Aquila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
High Risk ◽  
Aortic Valve ◽  
Hospital Mortality ◽  
Long Term Outcomes ◽  
High Risk Patients ◽  
Risk Patients

AbstractInfective endocarditis represents a surgical challenge associated with perioperative mortality. The aim of this study is to evaluate the predictors of operative mortality and long-term outcomes in high-risk patients. We retrospectively analyzed 123 patients operated on for infective endocarditis from January 2011 to December 2020. Logistic regression model was used to identify prognostic factors of in-hospital mortality. Long term follow-up was made to asses late prognosis. Preoperative renal failure, an elevation EuroSCORE II and prior aortic valve re-replacement were found to be preoperative risk factors significantly associated with mortality. In-hospital mortality was 27% in patients who had previously undergone aortic valve replacement (n = 4 out of 15 operated, p = 0.01). Patients who were operated on during the active phase of infective endocarditis showed a higher mortality rate than those operated on after the acute phase (16% vs. 0%; p = 0.02). The type of prosthesis used (biological or mechanical) was not associated with mortality, whereas cross-clamp time significantly correlated with mortality (mean cross-clamp time 135 ± 65 min in dead patients vs. 76 ± 32 min in surviving patients; p = 0.0005). Mean follow up was 57.94 ± 30.9 months. Twelve patients died (11.65%). Among the twelve mortalities, five were adjudicated to cardiac causes and seven were non-cardiac (two cancers, one traumatic accident, one cerebral hemorrhage, two bronchopneumonia, one peritonitis). Overall survival probability (freedom from death, all causes) at 3, 5, 7 and 8 years was 98.9% (95% CI 97–100%), 96% (95% CI 92–100%), 85.9% (95% CI 76–97%), and 74% (95% CI 60–91%) respectively. Our study demonstrates that an early surgical approach may represent a valuable treatment option for high-risk patients with infective endocarditis, also in case of prosthetic valve endocarditis. Although several risk factors are associated with higher mortality, no patient subset is inoperable. These findings can be helpful to inform decision-making in heart team discussion.

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