Infective Endocarditis Prevention and Antibiotic Prophylaxis

The life-threatening nature of infective endocarditis (IE) makes prevention imperative, but even in patients at highest risk, IE is uncommon and the development of evidence-based preventive strategies is challenging. Everyday bacteraemia, caused by chewing or toothbrushing, carries a baseline risk which must be assessed against the additional risk resulting from an invasive medical or dental procedure. Antibiotic prophylaxis for high-risk dental procedures remains an important but controversial component of prevention, with no definitive conclusion from studies analyzing the effects of its restriction. Given the increasing burden of healthcare-associated IE, rational prevention strategies should focus on the education of patients and healthcare professionals to restrict exposure to factors that trigger healthcare-associated IE.