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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the U.K. and Europe there are now simple oral chemoprophylaxis recommendations which are likely to be widely complied with by patients, dental and medical practitioners. The main recommendations of the 1982 BSAC Endocarditis Working Party report and the 1985 report of the European Society of Cardiology are similar and involve the administration of a single 3 g dose of oral amoxycillin 1 h before the procedure, or two doses of erythromycin for patients allergic to penicillin. Amoxycillin is more suitable than penicillin V for single dose chemoprophylaxis because of its higher and more persistent serum bactericidal concentrations and lower serum protein binding compared with penicillin V. Controversies about the precautions needed for patients with prosthetic valves are discussed. Erythromycin is associated with more frequent gastrointestinal side-effects and less reliable absorption than amoxycillin. None the less, recent studies suggest that the 1.5 g loading dose of oral erythromycin stearate has an 'immediate' effect in reducing post-extraction streptococcal bacteraemia and appears to be reasonably well tolerated by most adults. In 1986 a few changes have been suggested by the BSAC Endocarditis Working Party and concern the use of alternative oral amoxycillin regimens for patients requiring general anaesthesia, the giving of two administrations of amoxycillin within one month when prophylaxis is required for repeated dental procedures and the slower infusion of intravenous vancomycin to reduce the incidence of adverse reactions. A register of cases of failed chemoprophylaxis' has been started in the U.K. and also in Europe.
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PMID:Antibiotic prophylaxis of infective endocarditis in the United Kingdom and Europe. 311 57

General dental practitioners in the South West Region of the U.K. were surveyed to assess compliance with the recently published recommendations of the British Society for Antimicrobial Chemotherapy on the antimicrobial prophylaxis of infective endocarditis. For the majority of dental patients, the level of prophylaxis had improved compared with previous reports: 75% of practitioners organized the prophylaxis themselves, 80% gave oral amoxycillin to penicillin non-allergic patients, and 86% gave erythromycin to penicillin-allergic patients. Some 51% complied to an acceptable level with recommended amoxycillin schedules but only 2% complied with erythromycin schedules. The BSAC recommended prophylactic regimens have certainly improved compliance although they are not yet universally accepted.
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PMID:Antimicrobial prophylaxis of infective endocarditis: effect of BSAC recommendations on compliance in general practice. 358 72

The BSAC Guidelines on Endocarditis were last published in 1998. The Guidelines presented here have been updated and extended to reflect changes in both the antibiotic resistance characteristics of causative organisms and the availability of new antibiotics. Randomized, controlled trials suitable for the development of evidenced-based guidelines in this area are still lacking, and therefore a consensus approach has again been adopted. The Guidelines cover diagnosis and laboratory testing, suitable antibiotic regimens and causative organisms. Special emphasis is placed on common causes of endocarditis, such as streptococci and staphylococci, however, other bacterial causes (such as enterococci, HACEK organisms, Coxiella and Bartonella) and fungi are considered. The special circumstances of prosthetic endocarditis are discussed.
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PMID:Guidelines for the antibiotic treatment of endocarditis in adults: report of the Working Party of the British Society for Antimicrobial Chemotherapy. 1594 86

The BSAC guidelines on treatment of infectious endocarditis (IE) were last published in 2004. The guidelines presented here have been updated and extended to reflect developments in diagnostics, new trial data and the availability of new antibiotics. The aim of these guidelines, which cover both native valve and prosthetic valve endocarditis, is to standardize the initial investigation and treatment of IE. An extensive review of the literature using a number of different search criteria has been carried out and cited publications used to support any changes we have made to the existing guidelines. Publications referring to in vitro or animal models have only been cited if appropriate clinical data are not available. Randomized, controlled trials suitable for the development of evidenced-based guidelines in this area are still lacking and therefore a consensus approach has again been adopted for most recommendations; however, we have attempted to grade the evidence, where possible. The guidelines have also been extended by the inclusion of sections on clinical diagnosis, echocardiography and surgery.
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PMID:Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults: a report of the Working Party of the British Society for Antimicrobial Chemotherapy. 2208 58