Nuovi schemi di profilassi dell’endocardite batterica

Infective endocarditis is a life threatining condition with a mortality of up 30% even with antibiotic theraphy. Any dental procedures causes bacteriemia and it is believed that this may lead to infective endocarditis. There is a well established practice of administrating antibiotics to patients who are at risk of developing infective endocarditis prior to dental procedures during which a bacteriemia may develop. Specific guidelines are suggested by a working team of the British Society for Antimicrobial Chemotheraphy (BSAC); they have been published in the British National Formulary and its Italian version (AIFA, Agenzia Italiana del Farmaco). Recently, new guidelines have been proposed by the same BSAC; contrary to previous protocols, prophylaxis is now recomended in three cases only: previous infective endocarditis, prosthetic valves and pulmonary or systemic shunts. This radical step to limit prophylaxis to high risk patients seems to be rationale and has been welcomed by the international dental community. However, at the same time it is possible hat cardiologists and patients may fee uncomfortable about changing their usual recommendations.