Antiobiotic prophylaxis is different in guidelines

doi:10.1136/bmj.39520.546678.3A

BMJ 2008;336:630 (22 March), doi:10.1136/bmj.39520.546678.3A

Letters

Degenerative aortic stenosis

Antiobiotic prophylaxis is different in guidelines

The first 150 words of the full text of this article appear below.

Ramaraj and Sorrell recommend antibiotic prophylaxis for infectiveendocarditis in all patients with aortic stenosis.¹ This adviceis not in accordance with the most recent guidelines by theAmerican Heart Association on prevention of infective endocarditis.²According to these guidelines, antibiotic prophylaxis is indicatedonly for certain cardiac conditions with the highest risk ofinfective endocarditis. These include prosthetic heart valvesor prosthetic material used for cardiac valve repair, previousinfective endocarditis, unrepaired cyanotic congenital heartdisease (CHD), completely repaired congenital heart defect withprosthetic material, or CHD with residual defect at the siteor adjacent to the site of a prosthetic patch, and cardiac transplantpatients who develop cardiac valvulopathy. These guidelinesare based on the results of latest research that indicate thatfew cases of infective endocarditis would be preventable withantibiotic prophylaxis, even with 100% effectiveness assumed.³They also indicate that most patients with endocarditis on a. . . [Full text of this article]