[Current treatment of endocarditis : Innovations and controversies]

Internist (Berl). 2019 Oct;60(10):1111-1117. doi: 10.1007/s00108-019-00664-4.
[Article in German]

Abstract

Despite many novel diagnostic strategies and advances in treatment, infective endocarditis (IE) remains a severe disease. The epidemiology of IE has shifted and staphylococci have replaced streptococci as the most common cause and nosocomially acquired infections, invasive procedures, indwelling cardiac devices and acquired infections due to intravenous drug abuse are more frequent. The incidence of IE has steadily increased in recent years and the patients affected are older and have more comorbidities. The modern treatment of IE is interdisciplinary. The pharmacotherapy of IE depends on the pathogen and its sensitivity. The presence of a bioprosthetic valve and implantable cardiac devices plays a significant role in selection of antibiotics and duration of treatment. This article provides an update and overview of the current clinical practice in diagnostics and pharmacotherapy of IE in adults with a special focus on partial oral therapy and the role of aminoglycosides.

Keywords: Aminoglycosides; Antibacterial agents; Endocarditis, epidemiology; Foreign bodies; Staphylococcus.

Publication types

  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Comorbidity
  • Endocarditis / diagnosis
  • Endocarditis / drug therapy*
  • Endocarditis / epidemiology
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / epidemiology
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Incidence
  • Mycoses / diagnosis
  • Mycoses / drug therapy*
  • Mycoses / epidemiology

Substances

  • Anti-Bacterial Agents