Infective endocarditis: a comparison of international guidelines

Abstract

Since 1955, both national and international guidelines have evolved to aid the prophylaxis, diagnosis and treatment of this important disease. However, the nature of IE ensures that the evidence base from which these guidelines have traditionally been derived is limited to case–control cohort studies, animal data and expert consensus opinion. For both practical and ethical reasons, no large, well-designed, randomised controlled trial has been conducted on either prophylaxis or treatment of IE. Despite the absence of a strong evidence base, antibiotic prophylaxis before a range of dental and other surgical procedures in susceptible populations is universally practised in the developed world.