Allen U
Paediatr Child Health. 2010 Apr;15(4):205-12. doi: 10.1093/pch/15.4.205.
The most recent revision of the American Heart Association guidelines on infective endocarditis prophylaxis occurred in 2007. These revisions were based on the fact that current data have brought into question the benefit of previous recommendations for infective endocarditis prophylaxis. It was noted that the bacteremia that occurs following dental procedures represents only a fraction of the episodes of bacteremia that occur with activities of daily living (such as chewing, brushing teeth and other oral hygiene measures). The target groups and the procedures for which prophylaxis is reasonable have been significantly reduced in number. The focus is now on patients who are most likely to have adverse outcomes from infectious endocarditis. The present article is targeted at practicing Canadian physicians and provides the rationale for the current recommendations. In addition to a summary of the indications for prophylaxis, information is provided on the conditions for which prophylaxis is not recommended.
美国心脏协会关于感染性心内膜炎预防的指南最近一次修订是在2007年。这些修订基于以下事实：当前数据对先前感染性心内膜炎预防建议的益处提出了质疑。值得注意的是，牙科手术后发生的菌血症仅占日常生活活动（如咀嚼、刷牙和其他口腔卫生措施）中发生的菌血症发作的一小部分。预防合理的目标群体和手术数量已大幅减少。现在的重点是那些最有可能因感染性心内膜炎而产生不良后果的患者。本文针对加拿大执业医师，阐述了当前建议的依据。除了预防指征的总结外，还提供了不建议进行预防的情况的信息。
