Revised Guidelines for Endocarditis Prophylaxis: Resetting the Bar

Despite a lack of clinical evidence, previous practice guidelines have advised fairly broad use of antibiotics to prevent the devastating consequences of infective endocarditis. One of the principles driving the development of prior American Heart Association (AHA) guidelines was that antibiotic prophylaxis was considered effective for people undergoing dental, gastrointestinal (GI), or genitourinary (GU) procedures. However, since the 1997 revisions, the validity of this principle has been questioned. Although endocarditis causes significant morbidity and mortality, the condition is uncommon even among individuals with certain cardiac conditions: For example, the absolute risk for endocarditis in those with mitral valve prolapse is approxi…