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Prevention of infection by the interniste is less explored than perioperative prophylaxis. Basically, prophylaxis in internal medicine may be considered in the following situations: in case of chronic recurrent infections, in case of persisting infections, after contact with a dangerous microorganism, after contact with a potentially infectious vector, during bacteremia or in case of an anatomical defect. For some of these situations (malaria, tuberculosis, rheumatic fever) clear guidelines exist which, however, are rather based on the consensus of experts than on scientific data. For other diseases (e.g. chronic recurrent urinary tract infections) clinical studies are the basis for a rational proceeding. For a third group of situations (e.g.
Lyme disease, chronic bronchitis, leak of cerebrospinal fluid, implant) neither guidance nor sufficient clinical data exist. In these cases the proceeding is individual. The basis for the decision is given by clinical observations, single studies, theoretical considerations or cost-benefit analyses.