Authors

Pier Paolo Bassareo1, Luisa Marras2, Giuseppe Calcaterra3


Departments

1University College of Dublin, Mater Misericordiae University Hospital and Our Lady’s Children’s Hospital Crumlin, Dublin, Republic of Ireland - 2Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy - 3University of Palermo, Palermo, Italy

Abstract

Introduction: An amendment incorporated into the 2007 AHA and 2009 ESC guidelines on infective endocarditis led to a substantial restriction in indications for the administration of antibiotic prophylaxis. This may have resulted in a subsequent steady increase in the number of cases of infective endocarditis worldwide.

Methods: It has been hypothesised that susceptibility to infective endocarditis, together with effectiveness of antibiotic prophylaxis, may be linked to fluctuations of the immune system. Throughout a person’s lifetime, individual susceptibility to infective endocarditis may vary in an identical situation of risk.   As a consequence, a personalised targeted approach should be adopted when prescribing antibiotic prophylaxis to prevent onset of endocarditis, taking into account a series of factors including age, comorbidities, cortisol levels, and ethnicity. Children affected by bicuspid aortic valve and injection drug users are amongst the newly-emerging higher risk populations.

Conclusion: This up-to-dated narrative review summarizes all the available scientific evidence concerning the variable influence of the immune system on susceptibility to infective endocarditis.

Keywords

infective endocarditis, antibiotic prophylaxis, immune system, bacteria.

DOI:

10.19193/0393-6384_2021_1_55