[New guidelines in infective endocarditis and its dental and surgical aspects].

Abstract

Infective endocarditis is one of the most severe potential complications associated with dental procedures. The mortality of infective endocarditis is still high, but with application of prophylactic measures, the risk can be reduced. It is strongly recommended to be up-to-date with the new (2023) international guidelines and follow its recommendations. Several great works have been published previously in Hungary, now we would like to update them. The previous guideline from the European Society of Cardiology (ESC) was published in 2015. Since then, several new data have come out, resulting in the revision of the guideline. The main changes regarding oro-dental procedures include the more detailed specification of the group of patients with cardiovascular diseases who are recommended to use antibiotic prophylaxis. These affect the patients who live with congenital heart disease. Another major change is in the recommended list of antibiotics. Clindamycin was ruled out, the guideline now includes azithromycin and clarithromycin instead. Our guideline provides a detailed, yet simplified chair-side guide for infective endocarditis prophylaxis. This includes the indication of prophylaxis, antibiotic choice and dosage, available original medications, their dosage and contraindications. We also provide recommendations for the most common problems related to drug intake, like difficulty in swallowing and allergies. Orv Hetil. 2025; 166(5): 163–174.