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Infective Endocarditis (Guidelines on Prevention, Diagnosis and Treatment of)

ESC Clinical Practice Guidelines

Topics:

Infective Endocarditis

Current versions available to download

Publication dateVersionsReferencesSize
2004Full TextESC Web Site only332 KB
2004Executive SummaryEHJ 2004;25:267-276128 KB
 Pocket guidelines
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 Slideset3 MB

Current translated versions available to download:

Authors

D. Horstkotte (Chairperson), F. Follath, E. Gutschik, M. Lengyel, A. Oto, A. Pavie, J. Soler-Soler, G. Thiene, A. von Graevenitz

Table of contents: Full Text (ESC Clinical Practice Guidelines)

Introduction

Level of evidence

Definitions, terminology and incidence

Definition, Classification and terminology, Incidence

Prevention of infective endocarditis

Misconceptions, evidence and efficacy

Pathogenesis and pathology of native and prosthetic valve endocarditis

Pathogenesis, Pathology of native valve endocarditis, Pathology of prosthetic valve endocarditis (PVE) 6

Cardiac conditions/patients at risk

Patient conditions in which prophylaxis for IE is not indicated, Patient conditions in which prophylaxis is indicated, Patients carrying a high risk for IE

Patient-related non-cardiac conditions

 

Predisposing diagnostic interventions, Predisposing therapeutic interventions, Prophylactic antibiotic regimens, Patient education, information and acceptance

Diagnosis

 

History, symptoms, signs and laboratory tests

Echocardiography

 

Detection of vegetations, Valve destruction, Perivalvular complications, Echocardiographic findings in PVE, Echocardiographic findings in right-sided endocarditis, pacemaker and ICD lead infections

Standard blood culture techniques

Diagnostic approach in suspected but unproven IE

Culture-negative endocarditis (CNE)

Organisms requiring special culture

Conditions

Organisms requiring serology

Examination of valves, Culture of septic emboli, Demonstration of bacterial DNA by PCR

Treatment and management

Antibiotic treatment of streptococcal endocarditis

Choice and dosage of antibiotics

Penicillin, ceftriaxone, vancomycin and teicoplanin, Aminoglycosides, Antibiotic treatment regimens,
Home and outpatient treatment

Antibiotic treatment of staphylococcal endocarditis

Staphylococcal endocarditis not associated with prosthetic material

Staphylococcal endocarditis in patients with intracardiac prosthetic material

Antibiotic treatment for IE due to enterococci and penicillin-resistant streptococci

Antibiotic treatment of IE due to othermicroorganisms

IE caused by gram-negative organisms, Fungal IE

Drug level monitoring

Treatment under special circumstances, Culture negative endocarditis (CNE)

Endocarditis after intracardiac implantation of foreign material

Prosthetic valve endocarditis (PVE), Infection of other intracardiac foreign material

Treatment and management of infective endocarditis (IE) in intravenous drug abusers (IVDA)

Empiric antimicrobial therapy, Specific antimicrobial treatment, Surgical therapy, Influence of HIV-1 infection on the therapy of IE in IVDA

Pregnancy

Clinical disease monitoring and assessment of therapeutic efficacy

Management of complications

Embolic events

Patients at risk for embolic events, Prevention of embolic complications, Surgery after cerebal embolic events, Mitral kissing vegetation (MKV)

Management of pulmonary complications of right-sided endocarditis

Cardiac failure

Acute valve regurgitation, Myocarditis

Acute renal failure

Arrhythmias and conduction disturbances

Relapsing endocarditis

Surgery for active infective endocarditis

Summary of indications for surgery, Surgery for active NVE, Surgery for active PVE

Perioperative management

Preoperative considerations, Prevention of recurrences, Antithrombotic therapy, Intraoperative echocardiography, Intraoperative microbiology, Postoperative management

Intraoperative approach

Debridement, Methods for reconstruction and valve replacement, Right-sided endocarditis, Prosthetic valve endocarditis (PVE), Endocarditis in children with congenital heart disease, Endocarditis related to permanent pacemakers and defibrillators, Endocarditis in intravenous drug abusers (IVDA)

Outcome and long-term prognosis

Previous versions

A complete list of ESC Clinical Practice Guidelines (current and previous versions) endorsed by ESC National Society Members is available here