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Endocarditis

Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves.

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(Source: Wikipedia)

What works? Research summarized

Evidence reviews

Antibiotics for the prevention of bacterial endocarditis (severe infection or inflammation of the lining of the heart chambers) in dentistry

This review, carried out by authors of the Cochrane Oral Health Group, has been produced to determine whether people at increased risk of bacterial endocarditis, a severe infection or inflammation of the lining of the heart chambers, should routinely take antibiotics before invasive dental procedures in order to reduce the incidence of endocarditis, the number of deaths, and the amount of serious illness this group of people experiences.

Prophylaxis Against Infective Endocarditis: Antimicrobial Prophylaxis Against Infective Endocarditis in Adults and Children Undergoing Interventional Procedures [Internet]

Infective endocarditis (IE) is a rare condition with significant morbidity and mortality. It may arise following bacteraemia in a patient with a predisposing cardiac lesion. In an attempt to prevent this disease, over the past 50 years, at-risk patients have been given antibiotic prophylaxis before dental and certain non-dental interventional procedures.

The role of fluconazole in the treatment of Candida endocarditis: a meta-analysis

The treatment of Candida infective endocarditis generally involves infected valve removal accompanied by antifungal therapy with amphotericin B or a lipid-based derivative, with or without flucytosine. While often used as chronic suppressive therapy in these patients, the precise role for fluconazole has not been established. We conducted a meta-analysis of 64 literature cases of Candida endocarditis whose management did not include valve replacement but who received fluconazole, alone or concurrently or in sequence with 1 or more other antifungal drugs.Forty-nine (77%) patients were cured (n = 44) or improved (n = 5), 4 relapsed (6%), and 11 failed (10 of whom died) (17%). Among 19 patients for whom fluconazole was administered as the sole antifungal therapy, 11 (58%) were cured or improved. In contrast, among 45 patients who received 1 or more other antifungal agents in addition to fluconazole, 38 (84%) were cured or improved (p = 0.02). Eighteen of 21 (86%) patients with native valve infection were cured or improved compared with 13 of 19 (68%) patients with prosthetic valve endocarditis (p = 0.13). The mean duration of successful fluconazole regimens was 134 days. Twenty of 21 (95%) patients who received fluconazole as chronic suppressive therapy for ≥6 months were cured. Prognosis was independent of Candida species or patient age. Among 23 historical controls managed with fluconazole-containing antifungal therapy plus valvular surgery, survival was 91%.In conclusion, fluconazole-containing, combination antifungal therapy, with or without concomitant valve replacement, and followed by prolonged, perhaps indefinite fluconazole suppression, is effective in patients with Candida endocarditis.

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Summaries for consumers

Antibiotics for the prevention of bacterial endocarditis (severe infection or inflammation of the lining of the heart chambers) in dentistry

This review, carried out by authors of the Cochrane Oral Health Group, has been produced to determine whether people at increased risk of bacterial endocarditis, a severe infection or inflammation of the lining of the heart chambers, should routinely take antibiotics before invasive dental procedures in order to reduce the incidence of endocarditis, the number of deaths, and the amount of serious illness this group of people experiences.

Injectable gold for treating rheumatoid arthritis

Although its use can be limited by the incidence of serious harms, injectable gold has an important clinically and statistically significant benefit in the short term treatment of patients with rheumatoid arthritis.

A single beta lactam antibiotic versus a beta lactam‐aminoglycoside combination for patients with severe infection

Infections caused by bacteria and requiring hospitalization are a leading cause of preventable death. The beta lactam antibiotics (e.g. penicillins, cephalosporins) and the aminoglycosides (e.g. gentamicin) kill bacteria by different means. Combining a beta lactam with an aminoglycoside could, therefore, result in more effective treatment of patients with severe infection but with the side effects of both antibiotics. We reviewed clinical trials that compared intravenous treatment with a beta lactam versus treatment with a beta lactam plus an aminoglycoside.

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Terms to know

Endocardium
The endocardium is the innermost layer of tissue that lines the chambers of the heart.
Heart
The hollow, muscular organ that maintains the circulation of the blood.
Heart Valves (Cardiac Valves)
Any of the four heart valves that regulate the flow of blood through the chambers of the heart.
Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.

More about Endocarditis

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See Also: Infective Endocarditis

Other terms to know: See all 4
Endocardium, Heart, Heart Valves (Cardiac Valves)

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