[Is infective endocarditis prophylaxis always recommended?]

Infective endocarditis prophylaxis is a preventive strategy that has been recommended in various countries for more than 50 years. It is based on the plausible assumption that infectious endocarditis is, at least partially, avoidable. Traditionally, prophylaxis has consisted in the administration of an antibiotic agent in subjects with high-risk heart disease, or before high-risk interventions. More than 20 years ago, the indications of antibiotic prophylaxis were reduced and limited to high-risk patients and interventions, essentially valve replacement, or dental procedures with mucosal involvement, while the recommendations for overall non-antibiotic preventive measures, as well as recommendations for earlier diagnosis, have been reinforced.