Are Dentists in Our Environment Correctly Following the Recommended Guidelines for Prophylaxis of Infective Endocarditis?

Practical aspects of infective endocarditis prevention

The review is devoted to the practical aspects of infective endocarditis (IE) prevention, the issues of which, as before, remain the subject of lengthy discussions. Despite repeatedly updated national and international guidelines on this topic, medical practitioners are not always fully aware of antibiotic prophylaxis of IE. After a brief consideration of the etiological, pathogenetic features and risk factors of the disease, the main provisions of 2015 European Society of Cardiology guidelines on IE prevention, which were approved by the Russian Society of Cardiology, are presented. The categories of patients with the highest risk of IE, procedures associated with an increased risk of IE (dental and other invasive procedures) are described in detail. The main practical approaches to the identification of risk groups and performing invasive procedures that influence the decision to prescribe antibiotic prophylaxis are described. Particular attention is paid to the characteristics of both first-line antibiotic drugs and alternative agents for penicillin allergy or in cases of β-lactamase secreting pathogens.

[Antibiotic prophylaxis for infective endocarditis: current approaches]

This review addresses current views on prevention of infectious endocarditis (IE). History of establishing the concept of antibacterial prophylaxis (ABP), major approaches, and substantiation of changes in ABP in recent years are described. Recent international and national guidelines are highlighted, specifically, guidelines of the European Society of Cardiologists, American Heart Association/American College of Cardiology, and the Japanese Circulation Society. The review presents critical evaluation of previously approved international guidelines, including analysis of the effect of partial or complete ABP restriction on IE morbidity and incidence of complications. Special attention is paid to awareness of practitioners, particularly dentists, about ABP issues in their practice. Aspects of validity and key features of preventive approaches in implanting cardiac electronic devices and transcatheter aortic valve implantation are discussed.