The limits of antibiotic prophylaxis of infective endocarditis.

Objective - We performed this study in order to discuss the prevention guidelines presented during the consensus conference of the Societe de Pathologie Infectieuse de Langue Francaise (SPILF) on March 27, 1992. Despite the use of antibiotic prophylaxis for infective endocarditis, the incidence of this disease has not significantly decreased; this can be explained by poor compliance of physicians, dentists, and patients,- the increasing rate of invasive medical procedures, associated to higher bacteremia rates,. the increasing rate of infections by multidrug-resistant organisms; the risk of failure, because prophylaxis efficacy is not 100%; and the increasing risk of toxicity and allergy induced by the antibiotic agents. Material and method - We worked on the basis of a review of the literature. Results - The real efficiency of prophylaxis for infective endocarditis is still not proven today. This should lead to focusing efforts and attention on compliance within risk groups and situations, such as patients with a documented risk of cardiac disease (such as valvular prosthesis carriers), during dental and oral procedures, or during surgical procedures. (C) 2000 Editions scientifiques et medicales Elsevier SAS.