Antibiotic Prophylaxis for Prevention of Infective Endocarditis
Publication Date: December 31, 2007
Last Updated: March 14, 2022
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.
Overview
Title
Antibiotic Prophylaxis for Prevention of Infective Endocarditis