Procedures That May Require Antibiotics to Prevent Endocarditis
Topic Overview
Some people who are at risk for endocarditis take preventive (prophylactic) antibiotics before they
have certain dental or surgical procedures that could
put bacteria or fungi into their blood. The antibiotics lower the risk of
getting endocarditis.
Not all people who may have risk factors for endocarditis take antibiotics. The people who take antibiotics have certain heart conditions that make getting endocarditis even more
dangerous. If you do not have these conditions, antibiotics are not likely to help you.
These heart conditions include:
Talk to your doctor or dentist
Your doctor can tell you whether you need to take antibiotics. Before you
have any medical, dental, or surgical procedures, tell all other health
professionals who may treat you that you are at risk for endocarditis.
If your doctor or dentist recommends that you take preventive
antibiotics, the medicine typically is given 30 minutes to 1 hour before the
procedure.
What procedures need antibiotics?
| Dental procedures |
- Tooth removal (extractions), implants, or reimplantation of
teeth lost from injury
- Periodontal procedures, such as oral
surgery, scaling, root planing, and probing
- Gum
surgery
- Removal of stitches
- Initial placement of
orthodontic bands (not brackets)
- Teeth cleaning
|
| Respiratory tract (airway)
procedures |
- Tonsil or adenoid removal
- Respiratory tract
surgery or
biopsy
|
| Skin, bone, or tissue
procedures |
- Surgery that involves infected skin, bone, or muscle
tissue, such as surgery to remove infected bone (osteomyelitis)
or infected tissue
|
What procedures do not need antibiotics?
| Dental procedures |
- Tooth restoration or replacement, unless significant
bleeding is expected
- During the buildup of the new tooth material
phase of a root canal (intracanal endodontic treatment, post placement, and
buildup)
- Placement of rubber dams
- Placement,
adjustment, or removal of mouth (orthodontic) appliances (such as braces or
retainers)
- Oral impressions
- Mouth
X-rays
- Loss of baby tooth (primary tooth)
- Shots used to
numb the mouth
|
| Respiratory tract (airway)
procedures |
- Insertion of a tube through the nose or mouth to open or
widen the airway, give anesthesia, or remove secretions (endotracheal
intubation)
- A procedure in which a flexible tube is guided down
your throat to look into your breathing tubes (flexible bronchoscopy, with or
without biopsy)
- Eardrum incision for tube placement
(tympanostomy)
|
| Stomach and intestinal
tract procedures |
- All stomach and intestinal tract procedures and
surgeries
|
| Urinary system
procedures |
- All urinary system procedures and surgeries
|
| Other procedures |
- Cardiac catheterization, including balloon
angioplasty
- Implanted cardiac pacemakers
- Implanted
defibrillators and coronary stents
- Incision or biopsy of surgically
scrubbed skin
- Circumcision
- Ear and body
piercing
- Tattooing
- Hysterectomy
|
References
Other Works Consulted
- Wilson W, et al. (2007). Prevention of endocarditis.
Guidelines from the American Heart Association. A guideline from the American
Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease
Committee, Council on Cardiovascular Disease in the Young, and the Council on
Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the
Quality of Care and Outcomes Research Interdisciplinary Working Group.
Circulation. Published online April 19, 2007
(doi:10.1161/circulationaha.106.183095).
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
W. David Colby IV, MSc, MD, FRCPC - Infectious Disease |
|
Last Revised
|
March 9, 2011 |
Last Revised:
March 9, 2011
