Endocarditis prophylaxis in adult congenital heart disease

Q: What is the clinical evidence from this study?

Study design: Review. Population: Adult congenital heart disease. Intervention: Antibiotic prophylaxis.

Oktay Tutarel

doi:10.1016/j.ijcchd.2021.100141

April 24, 2021International Journal of Cardiology Congenital Heart DiseaseOpen Access

Endocarditis prophylaxis in adult congenital heart disease

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Key result

This review provides an overview of the evidence for and against antibiotic prophylaxis for infective endocarditis in adults with congenital heart disease.

Why the study?

Recommendations for infective endocarditis antibiotic prophylaxis have shifted due to missing evidence of effectiveness and concerns for adverse effects, creating debate and clinical uncertainty in adult congenital heart disease.

Does antibiotic prophylaxis prevent infective endocarditis in adults with congenital heart disease?

Key Points

Review the clinical evidence, historical evolution, and current controversies surrounding antibiotic prophylaxis against infective endocarditis in adults with congenital heart disease.
Narrative synthesis examining over sixty years of practice and guideline evolution for endocarditis prevention.
Evaluation of available evidence regarding prophylactic efficacy, potential medication adverse effects, and modern clinical application.
Adults with congenital heart disease experience an increased risk of infective endocarditis compared to the general population.
Guidelines over the past two decades shifted away from universal antibiotic prophylaxis due to a lack of robust evidence of efficacy and concerns over adverse effects.
Substantial controversy and uncertainty persist regarding how best to implement infective endocarditis prevention in routine clinical care.

Structured PICO

Does antibiotic prophylaxis prevent infective endocarditis in adults with congenital heart disease?

P

Population

Adults with congenital heart disease

I

Intervention

Antibiotic prophylaxis for infective endocarditis

This review summarizes the current evidence and ongoing debate regarding the use of antibiotic prophylaxis for infective endocarditis in adults with congenital heart disease.

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Implication

Emphasizes prophylaxis importance in adult congenital heart disease; leaves open antibiotic efficacy amid guideline shifts.

Abstract

The risk for infective endocarditis (IE) is increased in adults with congenital heart disease compared to the general population. Therefore, prophylactic measures are of utmost importance. Antibiotic prophylaxis (AP) for IE has been in use for more than six decades. However, a paradigm shift regarding the recommendations for AP occurred in the last two decades mainly due to the missing evidence for the effectiveness of AP as well as due to concerns for potential adverse effects. The consequences of these changes are still a matter of debate with a lot of uncertainty for the daily clinical practice. Therefore, this review aims to give an overview over IE prophylaxis in adult congenital heart disease: what it is, the evidence for and against it as well as how to apply adequate preventive measures.

Discussion

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Cite This Study

Oktay Tutarel (2021) conducted a review in Adult congenital heart disease. Antibiotic prophylaxis was evaluated. This review provides an overview of the evidence for and against antibiotic prophylaxis for infective endocarditis in adults with congenital heart disease.

synapsesocial.com/papers/6a992911c683007b2075cf34 https://doi.org/10.1016/j.ijcchd.2021.100141

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Endocarditis prophylaxis in adult congenital heart disease

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Endocarditis prophylaxis in adult congenital heart disease

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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