2015 ESC Guidelines for the management of infective endocarditis.
2015 ESC Guidelines for the management of infective endocarditis.
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2015 年 ESC 感染性心内膜炎治疗指南。
DOI：
10.1016/j.rec.2015.12.002
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
J. Zamorano
中科院分区：
文献类型：
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作者：
G. Habib;P. Lancellotti;M. Antunes;M. Bongiorni;J. Casalta;F. Zotti;R. Dulgheru;G. Khoury;P. Erba;B. Iung;J. Miro;B. Mulder;E. Plonska;S. Price;J. Roos‐Hesselink;U. Snygg;F. Thuny;P. T. Mas;I. Vilacosta;J. Zamorano
欧洲心脏病学会（ESC）的指南得到了西班牙心脏病学会（Sociedad Española de Cardiología，[SEC]）的认可，并被翻译成西班牙语发表在Revista Española de Cardiologia上。指南的每个更新版本都附有根据SEC临床实践指南委员会推荐的目的和方法撰写的评论文章。1本文由SEC委员会任命的专家小组起草，讨论了新的ESC感染性心内膜炎管理指南。[2] SEC临床心脏科招募的另一组专家，包括心脏成像专家，对本文做出了重要贡献。2015年指南是2009年发布的指南的更新。在6年的时间里，该领域取得了重要进展，证明了更新版本的出版是合理的：a）自从建议将预防性治疗限制在高风险情况下的高风险患者以来，出现了几个大型登记研究，得出了不同的结论，ESC更新其在这方面的立场似乎是适当的; B）描述了一种新的方法，包括在心内膜炎患者的护理中由不同学科的专家合作的专门单位，并且规定了转诊到这些单位的标准; c）一项比较药物治疗和手术治疗的随机研究3已经出现，尽管由于所述的局限性，相关证据没有实质性变化; d）在应用成像技术诊断心内膜炎方面取得了相当大的进展，这些重要的变化导致了诊断该疾病的新标准;以及e）对所提出的抗生素治疗进行了重大修改，主要集中在避免毒性。与2009年指南的情况一样，几乎没有高水平的证据支持当前更新中的建议，其中包括1个A级建议，48个B级（一半涉及抗生素治疗）和50个C级（13个涉及抗生素治疗
The guidelines of the European Society of Cardiology (ESC) are endorsed by the Spanish Society of Cardiology (Sociedad Española de Cardiología,[SEC]) and are translated into Spanish for publication in Revista Española de Cardiologia. Every updated version of the guidelines is accompanied by a commentary article written in accordance with the aims and methods recommended by the Clinical Practice Guidelines Committee of the SEC. 1 The present article, drafted by a team of experts appointed by the SEC Committee, discusses the new ESC guidelines for the management of infective endocarditis. 2 Another group of experts, recruited by the Clinical Cardiology Section of the SEC and including specialists in cardiac imaging, have made important contributions to the document presented here.The 2015 Guidelines are an update of those published in 2009. Over the intervening 6-year period, there have been important advances in the field that justify publication of an updated version: a) since the recommendation to restrict prophylaxis to high-risk patients in high-risk situations, several large registries have appeared, with different conclusions, and it seems appropriate that the ESC renew its position in this regard; b) a new approach is described, involving specialized units in which experts in different disciplines collaborate in the care of endocarditis patients, and the criteria for referral to these units is specified; c) a randomized study3 comparing medical treatment with surgical treatment has emerged, although the related evidence has not changed substantially because of the limitations described; d) there has been considerable progress in the application of imaging techniques to the diagnosis of endocarditis and these important changes have led to new criteria for diagnosing the disease; and e) substantial modifications have been made in the proposed antibiotic therapy, mainly focused on avoiding toxicity. As was the case of the 2009 guidelines, there is little high-level evidence to uphold the recommendations in the current update, which contains 1 Level A recommendation, 48 Level B (half referring to antibiotic therapy), and 50 Level C (13 referring to antibiotic