Infective endocarditis is microbial infection of the endovascular structures of the heart.
It often presents in an occult fashion and early diagnosis depends on a high index of clinical suspicion especially in patients with congenital heart disease, prosthetic valves or previous infective endocarditis.
The established diagnosis of infective endocarditis is demonstrated by a positive blood culture and involvement of the endocardium detected during sepsis or systemic infection. It may also be established if there is involvement of the endocardium detected during sepsis or systemic infection but blood culture is negative.
Long-term results of the POET* trial have suggested that patients with left-sided infective endocarditis (IE) could safely switch from conventional intravenous (IV) antibiotics to oral antibiotics, with oral antibiotics associated with a reduced mortality risk.
Outpatient parenteral antibiotic treatment (OPAT) may be a suitable option for individuals with infective endocarditis compared with hospital-based antibiotic treatment (HBAT), a recent study from Spain showed.
In patients with left-sided infective endocarditis in stable condition, switching to oral antibiotics is as effective and safe as continued treatment with intravenous (IV) antibiotics, according to results of the POET trial reported at the European Society of Cardiology (ESC) Congress 2018.
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In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.