Antibiotic Prophylaxis

Antibiotic prophylaxis guidelines exist for two groups of patients:

  • those with heart conditions that may predispose them to infective endocarditis; and
  • those who have a total joint replacement and may be at risk for developing hematogenous infections at the site of the prosthetic.

The current guidelines recommend use of preventive antibiotics prior to certain dental procedures for patients with:

  • artificial heart valves
  • a history of infective endocarditis
  • a cardiac transplant that develops a heart valve problem
  • total joint replacements
  • the following congenital (present from birth) heart conditions:*
  • or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
  • a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure
  • any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device
  • * Patients should check with their cardiologist if there is any question as to whether they fall into one of these categories.

Patients who took prophylactic antibiotics in the past but no longer need them include those with:

  • mitral valve prolapse
  • rheumatic heart disease
  • bicuspid valve disease
  • calcified aortic stenosis
  • congenital (present from birth) heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

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