##common.pageHeaderLogo.altText##

Viewpoint

Vol. 155 No. 6 (2025)

Update on prevention and antimicrobial prophylaxis of infective endocarditis

Cite this as:
Swiss Med Wkly. 2025;155:4169
Published
26.06.2025

Summary

The Swiss expert group published revised guidelines on the prevention and antibiotic prophylaxis against infective endocarditis in 2021. In this viewpoint article, the group reports on their experiences two years after implementing the new prevention concept, which included information flyers and antimicrobial prophylaxis cards. Challenges included communicating the concept and indications for antimicrobial prophylaxis to both high-risk patients and providers.

References

  1. Sendi P, Hasse B, Frank M, Flückiger U, Boggian K, Guery B, et al.; Swiss Medical Weekly. Infective endocarditis: prevention and antibiotic prophylaxis. Swiss Med Wkly. 2021 Feb;151(708):w20473. doi: https://doi.org/10.4414/smw.2021.20473
  2. ssi.guidelines.ch. Swiss Society for Infectious Diseases; c2024. Available from: https://ssi.guidelines.ch/guideline/2979/
  3. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al.; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct;116(15):1736–54. doi: https://doi.org/10.1161/CIRCULATIONAHA.106.183095
  4. Centre for Clinical Practice at NICE (UK). Prophylaxis against infective endocarditis: Antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. London: National Institute for Health and Clinical Excellence (UK); c2024. Available from: https://www.nice.org.uk/Guidance/cg64
  5. Geach T. Epidemiology: infective endocarditis rises as prophylactic antibiotic use falls. Nat Rev Cardiol. 2015 Jan;12(1):5. doi: https://doi.org/10.1038/nrcardio.2014.200
  6. Thornhill MH, Gibson TB, Cutler E, Dayer MJ, Chu VH, Lockhart PB, et al. Antibiotic Prophylaxis and Incidence of Endocarditis Before and After the 2007 AHA Recommendations. J Am Coll Cardiol. 2018 Nov;72(20):2443–54. doi: https://doi.org/10.1016/j.jacc.2018.08.2178
  7. Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023 Oct;44(39):3948–4042. 10.1093/eurheartj/ehad193 10.1093/eurheartj/ehad193
  8. Jaussi A, Flückiger U. Revidierte schweizerische Richtlinien für die Endokarditis-Prophylaxe. Kardiovaskuläre Medizin. 2008;11(12):392–400.
  9. Schweizerische Herzstiftung. Endokarditis. c2024. Available from: https://swissheart.ch
  10. Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA; ESC Scientific Document Group. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023 Pct 14:44(39):3948-4042.
  11. Bundesamt für Gesundheit. Kennzahlen zur Transplantation und zum Empfang von Organen. c2024. Available from: https://www.bag.admin.ch/bag/de/home/zahlen-und-statistiken/zahlen-fakten-zu-transplantationsmedizin/zahlen-fakten-zur-spende-und-transplantation-von-organen/kennzahlen-transplantation-und-empfang-von-organen.html
  12. Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S, et al.; International Society of Heart and Lung Transplantation Guidelines. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2010 Aug;29(8):914–56. doi: https://doi.org/10.1016/j.healun.2010.05.034
  13. Thornhill MH, Jones S, Prendergast B, Baddour LM, Chambers JB, Lockhart PB, et al. Quantifying infective endocarditis risk in patients with predisposing cardiac conditions. Eur Heart J. 2018 Feb;39(7):586–95. doi: https://doi.org/10.1093/eurheartj/ehx655
  14. Janszky I, Gémes K, Ahnve S, Asgeirsson H, Möller J. Invasive Procedures Associated With the Development of Infective Endocarditis. J Am Coll Cardiol. 2018 Jun;71(24):2744–52. doi: https://doi.org/10.1016/j.jacc.2018.03.532
  15. Thornhill MH, Crum A, Campbell R, Stone T, Lee EC, Bradburn M, et al. Temporal association between invasive procedures and infective endocarditis. Heart. 2023 Jan;109(3):223–31. doi: https://doi.org/10.1136/heartjnl-2022-321519