5 Hudson Harper University Hospital, 3990 John R, Detroit, MI 48201, USA.
Expert Opin Pharmacother. 2010 Feb;11(3):345-60. doi: 10.1517/14656560903496430.
Despite significant advances in medical, surgical, and critical care interventions, infective endocarditis (IE) remains a disease associated with considerable morbidity and mortality. Estimates from the American Heart Association place the incidence of IE in the US at 10,000 - 15,000 new cases each year. This may be due to the changing epidemiology of IE, including increasing antimicrobial resistance, increasing heart surgeries, prosthetic valve implantation, and widespread use of intravenous drugs. Furthermore, a new form of the disease, healthcare-associated IE, which is associated with new therapeutic modalities such as intravenous catheters, hyperalimentation lines, pacemakers, and dialysis shunts, has emerged.
We present the latest therapeutic and preventive strategies for IE caused by a variety of bacterial and fungal pathogens. The general methods employed included an extensive literature search, confined to the last 10 years, using key words such as 'infective endocarditis', 'culture-negative endocarditis', 'treatment guidelines for IE', and 'prophylaxis for IE'.
Comprehensive information regarding the changing epidemiology of IE is provided. The latest guidelines with respect to therapy and prophylaxis of IE are reviewed.
Successful management of IE depends on maintaining a high index of suspicion for the disease and, when IE is diagnosed, close cooperation of medical and surgical disciplines is required. Further research is needed to better understand and provide optimal therapy for complex situations such as multidrug-resistant and polymicrobial IE.
尽管在医学、外科和重症监护干预方面取得了重大进展，但感染性心内膜炎 (IE) 仍然是一种发病率和死亡率都很高的疾病。美国心脏协会的估计表明，美国每年新发 IE 病例数为 10000-15000 例。这可能是由于 IE 的流行病学变化，包括抗菌药物耐药性增加、心脏手术、人工瓣膜植入和静脉内药物广泛使用增加。此外，一种新形式的疾病，即与静脉导管、营养支持线、起搏器和透析分流器等新治疗方式相关的医源性 IE，已经出现。
我们介绍了由各种细菌和真菌病原体引起的 IE 的最新治疗和预防策略。所采用的一般方法包括广泛的文献检索，仅限于过去 10 年，使用的关键词有“感染性心内膜炎”、“培养阴性心内膜炎”、“IE 治疗指南”和“IE 预防”。
提供了关于 IE 流行病学变化的综合信息。回顾了关于 IE 治疗和预防的最新指南。
IE 的成功管理取决于对该病保持高度怀疑，并在诊断为 IE 时，需要医学和外科学科的密切合作。需要进一步研究以更好地了解和提供复杂情况（如多药耐药和多微生物 IE）的最佳治疗方法。
