Summary of major changes in updated document

Document Overview

Design and created by Guideline Central in participation with the American Dental Association.

Antibiotic Prophylaxis for Prevention of Infective Endocarditis

American Dental Association

Publication Date: Jan 1, 2008

Page Last Updated: May 6, 2026

Summary of major changes in updated document

We concluded that bacteremia resulting from daily activities is much more likely to cause infective endocarditis (IE) than bacteremia associated with a dental procedure.
We concluded that only an extremely small number of cases of IE might be prevented by antibiotic prophylaxis even if prophylaxis is 100 percent effective.
Antibiotic prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of IE.
Limit recommendations for IE prophylaxis only to those conditions listed in Box 3.
Antibiotic prophylaxis is no longer recommended for any other form of congenital heart disease, except for the conditions listed in Box 3.
Antibiotic prophylaxis is reasonable for all dental procedures that involve manipulation of gingival tissues or periapical region of teeth or perforation of oral mucosa only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE (Box 3).
Antibiotic prophylaxis is reasonable for procedures on respiratory tract or infected skin, skin structures or musculoskeletal tissue only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE (Box 3).
Antibiotic prophylaxis solely to prevent IE is not recommended for gastrointestinal or genitourinary tract procedures.
Although these guidelines recommend changes in indications for IE prophylaxis with regard to selected dental procedures (see text), the writing group reaffirms that those medical procedures listed as not requiring IE prophylaxis in the 1997 statement remain unchanged and extends this view to vaginal delivery, hysterectomy, and tattooing. Additionally, the writing group advises against body piercing for patients with conditions listed in Box 3 because of the possibility of bacteremia, while recognizing that there are minimal published data regarding the risk of bacteremia or endocarditis associated with body piercing.

Document Overview

Document Title: Antibiotic Prophylaxis for Prevention of Infective Endocarditis

Authoring Society: American Dental Association

Document Publication Date: Jan 1, 2008

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: jada.ada.org/article/S0002-8177(14)62745-8/fulltext?dgcid=PromoSpots_EBDsite_infective-endocarditis

Source Citation: DOI: https://doi.org/10.14219/jada.archive.2008.0346

Document Scope, Criteria, and Use Cases

Document Objectives: The purpose of this statement is to update the recommendations by the American Heart Association (AHA) for the prevention of infective endocarditis, which were last published in 1997.

Scope: Assessment and Screening, Prevention

Diseases/Conditions (MeSH)

D004697 - Endocarditis, Bacterial

D004696 - Endocarditis

D011315 - Preventive Medicine

D019072 - Antibiotic Prophylaxis

D011313 - Preventive Dentistry

D019072 - Antibiotic Prophylaxis

D011315 - Preventive Medicine

D004696 - Endocarditis

D004697 - Endocarditis, Bacterial

D011313 - Preventive Dentistry

Keywords: Antibiotic prophylaxis, antibiotic, endocarditis, infectious

Target Patient Population: Patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infectious endocarditis

Inclusion Criteria: Female, Male, Adolescent, Adult, Child, Older Adult

Health Care Settings: Ambulatory, Outpatient

Intended Users: Dentist, Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 147

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No