Infective endocarditis (IE), if inadequately treated, is fatal. Even with appropriate management, overall mortality rates range from 10% to 25% [1-3]. Clinical outcome is influenced by multiple factors, including valve characteristics, host factors, causative organism, development of intracardiac or systemic complications, and management options available.

The therapeutic modality initially used in the treatment of IE is medical. The role of surgery, however, continues to expand; aggressive surgical intervention, particularly in the early stages of developing complications, can be associated with a reduction in mortality. This chapter will focus on the role of medical, and where appropriate, surgical, management in native valve endocarditis. Discussion regarding newer antibiotics is provided. Endocarditis involving prosthetic valve/intravascular devices, as well as endocarditis in special patient subpopulations, such as in intravenous drug users and in immunocompromised hosts, are discussed in other chapters.

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