PREVENTION OF INFECTIVE ENDOCARDITIS: FUTURE DIRECTIONS
In the future, a greater emphasis may be placed on providing early patient education, especially for patients with recently implanted artificial valves or recently treated infective endocarditis. It is possible that the use of a wallet card or other such reminder system may be of use in providing accurate, easily accessible information to the patient and any’ provider preparing to perform a procedure.Given that animal data strongly support the efficacy of antibiotic prophylaxis, and that the practice is well-entrenched in modern medical care, it is unlikely that there will ever be a more definitive, randomized, placebo-controlled study to assess the efficacy of antibiotic prophylaxis of IE. Because the disease is rare, even in high-risk populations, it has been estimated that such a study would require more than 6000 high-risk patients undergoing procedures likely to induce bacteremia. However, future research can and should be performed to clarify important remaining questions, including how to improve physician and patient education on this topic, how to measure the effect of antibiotic doses on evolving resistance patterns, and how to measure the significance of post-procedural bacteremias.*52/348/5*
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