Abstract
Endocarditis is an infectious disease caused by numerous microorganisms, many of which habitually colonize the oral cavity and skin. Various bacteria and bacterial factors influence the duration of bacteremia and the possible colonization of cardiac valves. If not recognized and treated early, the disease may have serious consequences until death: despite the possibility of setting up targeted antibiotic therapy, it may occur in 30% of cases. This event is related to sepsis that develops in these patients and can result in cellular functional alterations in many districts, resulting in multi-organ failure (MOF) status. This paper is aimed to present an overview of this condition, based on the author’s own clinical experience and literature review.
Highlights
From an epidemiological point of view, the incidence of Infective Endocarditis (IE) varies considerably, depending on the socio-economic conditions of the various countries, with significantly lower rates in industrialized countries (USA 1.6–6 cases per 100,000 people per year)
We note that, in the literature and the evidence of clinical practice, when a history of probable cause is found among the most frequent statistical-epidemiological forms, besides the forms correlated to toxic-dependencies, IE are of primary relevance related to dental procedures in general and/or oral surgery, and they have a much higher incidence than the other types of instrumental maneuvers, and endoscopic procedures in general
In 2007 guidelines for antibiotic prophylaxis were been revised and, according to the current guidelines proposed by the AHA and the British Society for Antimicrobial Chemotherapy (BSAC) and implemented by AIFA (Italian Drugs Agency), there are four conditions that make antibiotic prophylaxis necessary before a dental procedure of any kind : 1) the presence of valve prostheses, 2) previous endocarditis, 3) previous pulmonary or systemic shunt interventions, and 4) cardiac transplant patients developing cardiac valvulopathy[16,17,18,19,20,21]
Summary
From an epidemiological point of view, the incidence of Infective Endocarditis (IE) varies considerably, depending on the socio-economic conditions of the various countries, with significantly lower rates in industrialized countries (USA 1.6–6 cases per 100,000 people per year). In addition to diagnosis and early treatment of the disease, prevention can be implemented through the application of correct hygienicbehavioral norms and by pharmacological prophylaxis protocols In this respect, we note that, in the literature and the evidence of clinical practice, when a history of probable cause is found among the most frequent statistical-epidemiological forms, besides the forms correlated to toxic-dependencies, IE are of primary relevance related to dental procedures in general and/or oral surgery, and they have a much higher incidence than the other types of instrumental maneuvers, and endoscopic procedures in general. In the case of renal failure, the single dose administration of the drug does not need to be modified
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