[Practical problems in the prevention of endocarditis]

Prophylactic antibiotic coverage of all interventions with a high risk of bacteremia is accepted practice in patients with valvular heart disease. A true cost-benefit ratio, however, has not been possible to demonstrate due to the low risk involved in these procedures, and therefore the current recommendations rely on experimental work with laboratory animals. Full application of these findings in patients is difficult and even so incapable of preventing the majority of cases of infective endocarditis.