Management of infective endocarditis: challenges and perspectives

Summary Despite improvements in medical and surgical therapies, infective endocarditis is associated with poor prognosis and remains a therapeutic challenge. Many factors affect the outcome of this serious disease, including virulence of the microorganism, characteristics of the patients, presence o...

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Bibliographic Details
Published in:The Lancet (British edition) 2012-03, Vol.379 (9819), p.965-975
Main Authors: Thuny, Franck, MD, Grisoli, Dominique, MD, Collart, Frederic, Prof, Habib, Gilbert, Prof, Raoult, Didier, Prof
Format: Article
Language:English
Subjects:
Antibiotics
Bias
Biological and medical sciences
Cardiology. Vascular system
Diagnosis
Disease
Drug therapy
Endocardial and cardiac valvular diseases
Endocarditis
Endocarditis, Bacterial - complications
Endocarditis, Bacterial - diagnosis
Endocarditis, Bacterial - mortality
Endocarditis, Bacterial - surgery
Fatalities
Fistula
General aspects
Gram-positive bacteria
Heart
Heart failure
Hospitals
Humans
Infections
Internal Medicine
Investigations
Management
Medical sciences
Mortality
Pathogens
Patients
Prognosis
Prostheses
Risk groups
Surgery
Virulence
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Summary:Summary Despite improvements in medical and surgical therapies, infective endocarditis is associated with poor prognosis and remains a therapeutic challenge. Many factors affect the outcome of this serious disease, including virulence of the microorganism, characteristics of the patients, presence of underlying disease, delays in diagnosis and treatment, surgical indications, and timing of surgery. We review the strengths and limitations of present therapeutic strategies and propose future directions for better management of endocarditis according to the most recent research. Novel perspectives on the management of endocarditis are emerging and offer hope for decreasing the rate of residual deaths by accelerating the process of diagnosis and risk stratification, reducing delays in starting antimicrobial therapy, rapid transfer of high-risk patients to specialised medico-surgical centres, development of new surgical methods, and close long-term follow-up.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(11)60755-1