Department of Medicine (DMED), University of Udine.
Cardiothoracic Department, University Hospital Santa Maria della Misericordia, ASUFC, Udine, Italy.
J Cardiovasc Med (Hagerstown). 2024 Oct 1;25(10):718-726. doi: 10.2459/JCM.0000000000001651. Epub 2024 Jul 19.
The 2023 European Society of Cardiology (ESC) guidelines for the management of infective endocarditis update the previous 2015 guidelines with main novelties in five areas: (1) antibiotic prevention for high-risk patients, and prevention measures for intermediate-risk and high-risk patients; (2) diagnosis with emphasis on multimodality imaging to assess cardiac lesions of infective endocarditis' (3) antibiotic therapy allowing an outpatient antibiotic treatment for stabilized, uncomplicated cases; (4) cardiac surgery with an emphasis on early intervention without delay for complicated cases; and (5) shared management decision by the endocarditis team. Most evidence came from observational studies and expert opinions. The guidelines strongly support a patient-centred approach with a shared decision process by a multidisciplinary team that should be implemented either in tertiary referral centres, becoming heart valve centres, and referral centres. A continuous sharing of data is warranted in the hospitals' network between heart valve centres, which are used for referrals for complicated cases of infective endocarditis, and referral centres, which should be able to manage uncomplicated cases of infective endocarditis.
2023 年欧洲心脏病学会 (ESC) 感染性心内膜炎管理指南更新了 2015 年的旧指南，主要在五个方面有新的内容：（1）高危患者的抗生素预防，以及中危和高危患者的预防措施；（2）诊断方面强调多模态成像，以评估感染性心内膜炎的心脏病变；（3）抗生素治疗，允许稳定、无并发症的病例进行门诊抗生素治疗；（4）心脏手术方面强调早期干预，无需延迟治疗复杂病例；（5）感染性心内膜炎团队的共同管理决策。大多数证据来自观察性研究和专家意见。指南强烈支持以患者为中心的方法，由多学科团队进行共同决策，应在三级转诊中心、成为心脏瓣膜中心和转诊中心实施。心脏瓣膜中心和转诊中心之间应在医院网络中进行数据的持续共享，心脏瓣膜中心用于转诊复杂感染性心内膜炎病例，而转诊中心应能够治疗简单的感染性心内膜炎病例。
