Abstract
To use as well the right antimicrobial therapy as well as surgical treatment in right time and case of infectious endocarditis patients is part of a guideline-consented therapy. The clear indication for starting a define adequate therapy is based on an interdisciplinary collaboration with crucial key-findings AND an early decision-competence which should be present not only in the circle of the cardiac specialists when based e.g. on the duke criteria. Due to the fact that inattention or indecisiveness can lead to harmful delay in therapy sometimes followed by drastic complications like septic emboli a simplification of setting the diagnosis and the fitting therapy in a non-specialist´s hand would be favorable. With look on preferentially single-case-studies of most differing agents of endocarditis in literature there is no clear experience-based knowledge besides the common therapy of staphylococci, streptococci, enterococci, HACEK or Bartonella. We here review results from current multi -centre -studies to cope the limitations by case-reports and find experience-based strategies besides the usage of current guidelines. Especially for the treatment of prosthesis endocarditis the data are rare to bring up crucial improvements. Until now there is no follow-up-strategy for endocarditis-patients in the face of bacterial agents´ adaptiveness creating residual infections in inactive and resistant stadiums.
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