Prevention of Infective Endocarditis

Infective endocarditis is always fatal if untreated and continues to cause substantial morbidity and mortality despite modern antimicrobial and surgical treatment.15 Therefore, prevention is a priority. In 1909, Lord Thomas Horder wrote that when “infection is grafted upon a previously sclerosed endocardium . . . it is possible to do something to prevent the mischief. . . . The source of the infecting agent in most of the cases is the mouth or the intestine. . . . Attention might profitably be directed to these regions in all persons known to possess valvular defects.”6 Today we continue efforts “to . . .