[Contribution of the new guidelines for the management of infective endocarditis]

Contribution of the new guidelines for the management of infective endocarditis. New guidelines for the management of infective endocarditis (IE) have been recently published both in United States and in Europe. Although identification responsible micro-organism by blood culture and assessment of cardiac lesions by echocardiography remain the cornerstone of the diagnosis of IE, recommendations insist on the additive interest of multimodality imaging including cerebral MRI, MSCT and nuclear imaging (Pet CT) in the diagnosis of both cardiac and extracardiac lesions of IE. Regarding prophylaxis, antibiotic prophylaxis before dental procedures at risk in high risk patients is still recommended. Furthermore, all patients should be advised of the importance of dental and cutaneous hygiene. Recommendations on antibiotic therapy no longer advocate the use of aminoglycosides in case of staphylococcal native IE. Finally, recommendations strongly support the management of patients with IE in reference centres by a specialized team (the 'Endocarditis Team') including cardiologists, ID specialists, cardiac surgeons, microbiologists, imaging specialists and any specialist implied in the management of IE patients.