Profilaxia antimicrobiana para endocardite infecciosa : evolução dos protocolos da American Heart Association.

Abstract

ABSTRACT The Infective Endocarditis (IE) is caused by bacteremia that reaches the endocardium or the heart valves, being the endocardium previously damaged by congenital or acquired cardiopathy, and underlying, it promotes an adherence and multiplication of microorganisms.The American Heart Association (AHA) organizes periodically prevention protocols of IE. Therefore, the aim of this study is to evaluate the evolution of antimicrobial prophylaxis recommendations according to AHA. In this literature review, BIREME and PubMed databases and Periodic Portal CAPES were consulted, in English, Spanish, French and Portuguese, comprehending the period of 1955 to 2015.Based on the analysis of ten protocols formulated by AHA, we can, realize that the alterations made over time were guided, basically, considering the cardiac conditions that, throughout the life, have a bigger predisposition to get IE, or that are associated with an unfavorable outcome of IE, and, beyond that, it contains updates related with the type of medication, route of administering, dosage and period of time to be administered. So, only patients who are at high risk to develop IE, must be treated by antimicrobial prophylaxis before dental procedures. However, only procedures that implicate manipulation of gingival tissues, periapical region of teeth or perforation of oral mucosa, can get benefits of antimicrobial prophylaxis, being this method unnecessary in other cases. The antimicrobial prophylaxis to IE is a preventive procedure that aims decrease the bacteremia risk during invasive dental procedures. However, some spontaneous transitory bacteremia often happens during toothbrushing and chewing food. It can to influence the development of IE as well as dental procedures. Then, currently the promotion and maintenance of health and oral hygiene is indispensable and priority to reduction of risks to endocarditis.