Antibiotic Prophylaxis Recommendations
American Heart Association 2007
American Dental Association 2007
Conditions for which Antibiotic Prophylaxis IS recommended.
- Prosthetic Joint Replacement within 2 years
- Prosthetic cardiac valve
- Previous infective endocarditis
- Congenital heart disease (CHD) *
- Unrepaired cyanotic CHD, including palliative shunts and conduits
- Completely repaired congenital heart defect with prosthetic material or device, whether place by surgery or by catheter intervention, during the first six months after the procedure. #
- Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which would inhibit endothelialization)
- Cardiac transplantation recepients who develop cardiac valvulopathy
* except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of CHD.
# prophylaxis is recommended because endothelialization of prosthetic material occurs within the first six months after the procedure.
Previous Conditions for which Antibiotic Prophylaxis is NO LONGER Recommended
· Mitral Valve Prolapse (MPV)
· Rheumatic heart disease
· Bicuspid valve disease
· Calcified aortic stenosis
· Congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy.
Summary of Major Changes in Updated Document
- Bacteremia resulting from daily activities is much more likely to cause infective endocarditis (IE) that bacteremia associated with a dental procedure
- 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 no longer recommended for any other form of congenital heart disease, except for those listed above.
- Antibiotic prophylaxis is recommended 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.