Flachskampf Frank Arnold
Institutionen för Medicinska Vetenskaper, Uppsala Universitet, Uppsala, Schweden.
Dtsch Med Wochenschr. 2024 Nov;149(22):1356-1360. doi: 10.1055/a-2263-3573. Epub 2024 Oct 22.
A succinct summary of the 2023 guidelines on the management of infectious endocarditis of the European Society of Cardiology is presented. Main new aspects are (1) the importance of treating endocarditis at a hospital with an endocarditis team and cardiac surgery, (2) a less restrictive recommendation for antibiotic prophylaxis, which now favors an individualized indication in patients with risk, e.g. bicuspid aortic valve and degenerative or rheumatic native valve disease, undergoing orodental interventions, while there is a clear recommendation for prophylaxis in patients (e.g. having prosthetic valves). (3) In patients with left-sided endocarditis caused by streptococci, enterococcus faecalis, staphylococcus aureus, or coagulase-negative staphylococci, who are after at least 10 days of in-hospital intravenous appropriate antibiotic therapy, step-down ambulatory (oral or parenteral) further antibiotic therapy is recommended.