A critical appraisal of the quality of the management of infective endocarditis

J Am Coll Cardiol. 1999 Mar;33(3):788-93. doi: 10.1016/s0735-1097(98)00624-x.


Objectives: The purpose of this study was to assess the quality of the management of infective endocarditis.

Background: Although many guidelines on the management of infective endocarditis exist, the quality of this management has not been evaluated.

Methods: We collected data on all patients (116) hospitalized with infective endocarditis over 1 year in all hospitals in the Rhône-Alpes region (France).

Results: Prophylactic antibiotics were not given before infective endocarditis to 8/11 cardiac patients at risk and who underwent an at risk procedure. Among the 55 cardiac patients at risk and with fever and who consulted a physician, blood cultures were not performed before antibiotic therapy was initiated for 32 patients. In-hospital antibiotic therapy was incorrect for 23 patients. The portal of entry was not treated for 16/61 patients with an accessible portal of entry. Among the 19 patients who had severe heart failure or fever persisting more than 2 weeks in spite of antibiotic therapy and who could have undergone early surgery, surgery was delayed for five, and not performed for three. Overall, the average score was 15/20.

Conclusions: More information on the management of infective endocarditis should be widely disseminated to the physicians' and the dentists' communities and to the patients at risk.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Cardiac Surgical Procedures*
  • Endocarditis, Bacterial / epidemiology
  • Endocarditis, Bacterial / therapy*
  • Female
  • France / epidemiology
  • Hospitalization
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Population Surveillance
  • Prognosis
  • Prospective Studies
  • Quality Assurance, Health Care*
  • Survival Rate


  • Anti-Bacterial Agents