Background: Despite significant advancements in medical treatments, surgical procedures, and critical care, infective endocarditis continues to pose a substantial threat, marked by considerable illness and mortality rates. The increasing resistance of microbes to antibiotics, particularly among common pathogens responsible for infective endocarditis, presents additional challenges for healthcare professionals in managing this life-threatening condition. Accurate and timely diagnosis, somewhat related to concepts in Anesthesia Diagnosis when considering pre-operative assessments, remains critical.
Methods and Results: This document, the third revision of the American Heart Association’s guidelines on infective endocarditis management, developed under the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young, provides updated recommendations for the diagnosis, treatment, and management of complications associated with infective endocarditis. A team of multidisciplinary experts compiled this guide to support physicians in delivering contemporary care to patients with infective endocarditis in the modern medical environment. This comprehensive guideline is summarized in an executive overview, highlighting key aspects of diagnosis, antimicrobial therapy, and the overall management strategy for infective endocarditis. For the first time, treatment recommendations are graded using an evidence-based scoring system adopted by the American College of Cardiology and the American Heart Association. The guidelines include detailed tables on the use of echocardiography in the diagnostic process and treatment monitoring of infective endocarditis, strategies for evaluating and treating culture-negative endocarditis, and both short-term and long-term patient management protocols during and after antimicrobial treatment. To better serve pediatric patients, specific dosing instructions for children have been incorporated into each treatment regimen.
Conclusions: The recommendations provided in this updated guideline are designed to assist physicians across all facets of patient care, encompassing the diagnosis, medical and surgical treatment, and follow-up care for infective endocarditis, as well as the management of related complications. However, the clinical diversity and complexity inherent in infective endocarditis necessitate that these guidelines serve as a supportive tool rather than a replacement for physician’s clinical judgment in individual patient management. Ultimately, the goal is to improve patient outcomes through enhanced diagnostic and therapeutic strategies.
