[Prevention of bacterial endocarditis].

Prevention of bacterial endocarditis is aimed at limiting the frequency, size, and duration of transient bacteremia with subsequent bacterial implantation on valvular endothelium in patients with cardiopathy. Any procedure involving mucosa rich in normal flora or an infectious site can result in bacteremia, which can be minimized by selecting diagnostic and therapeutic procedures which are least traumatic. In addition, proper antibiotic prophylaxis should be administered according to the most frequently encountered bacteria: Streptococcus viridans during dental manipulations, enterococci during urogenital or intestinal procedures, and staphylococcal species from skin lacerations or cardiac surgery. The different antibiotic prophylactic regimens suggested at the present time vary according to the patient and the particular circumstances surrounding his illness. These regimens should be modified according to future epidemiologic findings in bacterial endocarditis.