Infective Endocarditis: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: Endorsed by the Infectious Diseases Society of America
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Background— Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. Methods and Results— This work represents the third iteration of an infective endocarditis “treatment” document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. Conclusions— The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management.
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The 2005 AHA document recommended streptomycin for patients with gentamicin-resistant strains of enterococci.
“The 2005 AHA document 12 recommended streptomycin for patients with gentamicin-resistant strains of enterococci.”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [12]
The section on enterococci resistant to gentamicin recommends a streptomycin regimen, but specifically for strains susceptible to streptomycin, penicillin, and vancomycin. It says only some gentamicin-resistant strains remain susceptible to streptomycin, so the claim is too broad without that qualification. No page number is available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe benefits of early surgery were demonstrated in the prospective, randomized trial discussed earlier.
“The benefits of early surgery were demonstrated in the prospective, randomized trial 12 that was discussed earlier in this document.”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [12]
The Risk of Embolization section says the benefit of surgery to avoid catastrophic embolic events is greatest early in the treatment of infective endocarditis. It does not say that a prospective randomized trial demonstrated that benefit; that part of the claim is unsupported by this source. (LLM, conf=0.84)
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Self-citation
- Authors
- Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Bolger, A. F., Levison, M. E., Ferrieri, P., Gerber, M. A., Tani, L. Y., Gewitz, M. H., Tong, D. C., Steckelberg, J. M., Baltimore, R. S., Shulman, S. T., Burns, J. C., Falace, D. A., Newburger, J. W., Pallasch, T. J., Takahashi, M., & Taubert, K. A.
- Affiliations
- American Heart Association (US)
- ORCID
- Venue
- Circulation
- Published
- 2005-06-14
- Volume
- 111
- Issue
- 23
- Pages
- e394-434
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2118546214
- Cited by
- 1,707
- References
- 286
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 22 · 2023: 22 · 2022: 16 · 2021: 30 · 2020: 49 · 2019: 56 · 2018: 44 · 2017: 69 · 2016: 96 · 2015: 141 · 2014: 154 · 2013: 153 · 2012: 124
- FWCI
- 69.32
- Type
- journal article
- Language
- en
- Update notices
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Bristol-Myers Squibb
- Sanofi
- Yale University
- University of Southern California
- Children's Hospital Los Angeles
- Cincinnati Children's Hospital Medical Center
- Bunning Food Allergy Institute, Ann and Robert H. Lurie Children's Hospital of Chicago
- University of Minnesota
- Drexel University
- School of Medicine
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Keywords
- infective endocarditis, antimicrobial therapy, antimicrobial resistance, culture-negative endocarditis, echocardiography, endocarditis complications, pediatric dosing, treatment guidelines
- MeSH terms
- Ambulatory Care, American Heart Association, Anti-Infective Agents, Bacteria, Cardiovascular Diseases, Echocardiography, Endocarditis, Bacterial, Humans, Evidence-Based Medicine, Disease Management
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