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Management of Infective Endocarditis: A Scoping Review
Franck Mbuntcha Bogni1, Julia S Gillette1, Vijairam Selvaraj2,3
1Warren Alpert Medical School of Brown University.
Journal of Brown Hospital Medicine
|July 6, 2026
Summary
Infective endocarditis mortality remains high, with Staphylococcus aureus now the leading cause due to increased intravenous drug use and healthcare infections. Treatment requires targeted antibiotics, especially for complex cases involving prosthetic valves or devices.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Infective endocarditis (IE) presents a significant mortality risk.
- The epidemiology of IE is shifting, with Staphylococcus aureus emerging as the predominant pathogen, surpassing viridans streptococci.
- Factors contributing to this shift include rising rates of intravenous drug use and healthcare-associated infections.
Purpose of the Study:
- To highlight the changing landscape of infective endocarditis pathogens.
- To emphasize the challenges in managing IE, particularly in patients with prosthetic valves or intracardiac devices.
- To underscore the importance of pathogen identification and antimicrobial susceptibility in guiding treatment.
Main Methods:
- Review of epidemiological trends in infective endocarditis.
- Analysis of common causative agents, focusing on Staphylococcus aureus.
- Discussion of treatment strategies and complications.
Main Results:
- Staphylococcus aureus is now the most common cause of infective endocarditis.
- Intravenous drug use and healthcare-associated infections are key drivers of this epidemiological shift.
- Prosthetic valve endocarditis and infections involving intracardiac devices are associated with worse outcomes.
Conclusions:
- Effective management of infective endocarditis necessitates prompt diagnosis and pathogen-specific antimicrobial therapy.
- The increasing prevalence of Staphylococcus aureus in IE poses significant clinical challenges.
- Patients with prosthetic material or devices require specialized management approaches due to increased risks.
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