Infective Endocarditis

To the Editor: In their review on infective endocarditis, Hoen and Duval (April 11 issue)(1) advocate that when valve replacement is performed during antibiotic treatment for native-valve infective endocarditis, antimicrobial therapy should not be switched to that recommended for prosthetic-valve infective endocarditis. Although supported by few data, such a strategy is in line with the 2009 European Society of Cardiology guidelines.(2) However, to our knowledge, only one retrospective study conducted at a single center with a small sample is available on the topic, and it showed cure rates that were similar regardless of the antimicrobial regimen administered.(3) By contrast, the 2005 American Heart Association guidelines recommend that for patients with native- valve infective endocarditis who undergo valve replacement with a prosthetic valve, the postoperative treatment regimen should be the one recommended for the treatment of prosthetic- valve infective endocarditis rather than the one recommended for the treatment of native- valve infective endocarditis. 4 Thus, regarding valve replacement performed during antibiotic treatment of native- valve infective endocarditis, there is still debate about whether to switch antimicrobial therapy to the treatment recommended for prosthetic- valve infective endocarditis. Further studies are needed to address this critical issue.