Endocarditis in the 21(st) Century.

Endocarditis still carries a poor prognosis despite improvement in preventive strategies and advances in diagnosis and also in treatment. Epidemiology of infective endocarditis (IE) has changed in late years. Contemporary antibiotic overuse determines antibiotic resistance against microorganisms involved in IE. Prophylaxis principles have been changed and restricted in order to avoid excessive antibiotic use and unfounded costs. Current guidelines are often based on expert opinion because of the low incidence of the disease, the absence of randomized trials, and the limited number of meta-analyses. The present review will focus on current changes in epidemiology, prophylaxis, diagnosis and treatment options.