Bacterial endocartis prevention

[dano]

Have been having to take an antibotic regimen before going to the dentist for some time. But, after having an aortic mechanical valve implanted, they told me at the cardiologist office that I was now considered a high risk and to follow the high risk regimen before going to the dentist. That now involved a shot or IV to receive ampicilin and gentamicin and then some pills after the procedure. That turned into an out-patient trip for me to the hospital. Just wondering if that is the norm for other folks with a mechanical valve.

 

[Zipper]

That's news to me..I have always followed the guideline of taking 2000 mg of Trimox 1 hour before any dental procedure (cleanings included).

A few years back the standard was a higher amount taken before AND after procedure, but as far as I know the above is routine now.

Zip/Joan

 

[Mark Wagner]

Same thing as Zipper. I just take some antibiotic; pill form; one hour before I see the dentist. I have never heard of such a thing to see the dentist, from other mechanical valve patients. Maybe your case is a little different.
Take care ... Mark

 

[EVELYN]

US, TOO!!! TYCE JUST TAKES AMOXICILLIN 4-500 MG. 1 HOUR BEFORE ANY PROCEDURE......EVELYN

 

[Georgia]

WHEW!!! I've been holding my breath until I saw some answers to this post; I'm 7 weeks out from my surgery, and have had to go to the dentist yet. As much dental work as I have every year the very THOUGHT of having IV antibiotics for each procedure gives me the willies.

Thank for answering, folks.

Georgia

 

[hhardt]

Wow! My requirement is for four (4) Clindamycin 150 mg cap 1 hour before cleaning or other dental procedures. Of course you must check to see why the apparently over precaution. It could be that other cooties were at play. The norm is for the mouth applied as you can see from the other posts.

 

[Blanche]

Dano
Albert has been on the high risk protocol since October 1990 when he received his heart valve. Until recently he went to the hospital outpatient for IV meds. Now, his internist handles that in his office, saving us a ton of money and time. Albert was taking oral antibiotics because of a mitral valve prolapse. The bacteria broke through and he got endocarditis, which lead to the heart valve replacement. In l990 the protocol you describe, gentamicin IV, etc. was considered standard treatment for those with prosthetic heart valves. I'm not sure when the protocol changed, but I seem to remember l995. I could be wrong.
Blanche

 

[Granbonny]

Dental work

Dental work

I, too, take 2,000 mg. of Trimox before cleanings. Last week, I had a regular cleaning. No bleeding BUT have notice the past few days. I have some "hanging white blisters on my upper inside gums.. Never happen with my 2 deep cleaning last Dec. The only thing different, she massage my gums real hard. Anyone else ever had those? They are not painful..Just hanging there. Gross Which member has the dental wife? Maybe she would know? Bonnie

 

[medtronic of borg]

hemmm

hemmm

that seems excessive to me! But perhaps he could give you a good reason for IV drugs(costly) opposed to oral meds.
Medtronic

 

[JAMES W]

Pre-Medicate

Pre-Medicate

I too had a cleaning just 3 weeks ago...The new standard AHA guidelines suggest 600 mg Clindimycine 1 hour before any dental procedure.....worked fine...no problems...I used to have to pre-medicate 3-4 day prior and then 3-4 days post....This is much easier...

Good Luck...

James W

 

[csutherland]

Maybe I should start a new thread, but this one concerns dental work so I'll tag on to it.

Jerry, as I've mentioned before, has every single tooth in his mouth crowned. This was done in early 2000. He has had premeds for any cleaning, etc. since. Yesterday one of the crowns broke off at the gumline, tooth stump and all! He saw the specialist who did the original crowns and he has no idea why that would happen, but got him an appointment with a root canal specialist for Monday. The dentist is a little concerned that it could abcess before the root canal gets done, which scares me to death with a mechanical valve. He has a prescription for Trimox 500mg to be taken 1 hr before the procedure.

Neither of us has had a root canal before. Do they bleed much? The dentist wasn't concerned about Coumadin, but Jerry called his cardio and the nurse said no adjustments were needed. Does that sound right to you all?

 

[ILoVeNY25]

Hi Celia, I wouldn't worry about any bleeding. Root canals don't require any cutting of the gums. Just some drilling. I don't think it's necessary for his Coumadin to be adjusted. There might be some bleeding when being fit with a new crown though, Probably not this visit. Just make sure Jerry takes his pre-meds and I'm sure everything will be fine. Take care!

 

[Rich]

Same here, 2000mg of amoxicillin one hour before.
Iv'e got a mouthful of caps and crowns, root canals should not cause any bleeding but check with the dentist to be sure.
And they are not near as bad as some people make them out to be.
The first time I needed some he did five at one sitting, no problem.

 

[RWS]

High Risk

High Risk

dano, it's not the norm for mech. av but may be for higher risk. Let me expalin. I have had endocarditis three times, not fun. After the first time I elected not to take IV antibiotic, only oral before dental work. A few years later I needed a root canal, infection etc. I did the oral antibiotic regiment for 14 days. Three weeks later, bacterial strep endocarditis. Now, I was told I was well above high risk and since then I followed the IV recommendations. So far I was lucky enough not to have any further valve damage due to immediate treatment and the bacteria was strep, not staph. Strep being easier to treat but still risky. Please all, don't make the following mistake! Dental work is only one way endocarditis can be contracted. My third round of endocarditis was due to a staph infection from a simple cut on my leg. The staph was relentless, 22 days in the hospital before surgery. Now I also have a mech. av BUT, I am now at a lower risk than before and I am back on the oral antibiotic plan before dental work. My point being there are instances where IV is the proper prevention

Randy

 

[Beverly]

Bacterial endocarditis prevention

Bacterial endocarditis prevention

I have been following this procedure of IV antibiotics 1 hour before and 1000 mg amoxil tablets 6 hours after dental cleanings etc. since 1990. This was the recommendation of my surgeon and my primary cardiologist has continued this course ever since.

 

[loz]

Hi:
My son had a konno procedure and aortic mechanical valve put in. would he need antibotic cover before any dental procedure or would it be just some dental procedures.Please let me know
Regard,s Loz

 

[Enudely]

I had endocarditis last summer and now have an insufficient valve that will need to be replaced sometime in the somewhat near future. When I had the bacteria, I wan on ampcillin and gentomiacin for six weeks and it was a nightmare!!
I'm so sorry you have to do that every time you go to the dentist and I am suddenly very scared that I will have to do the same!!
I was told by a dentist that a particular dose of ampicillin one hour before dental work has been found to be totally sufficient for warding off bacteria. Of course, I have felt sort of like I needed more for added protection!!! Another infection in my heart would be bad. I can't believe you've had three!! That is scary!!
I always thought that you could only get endocarditis at the dentist or through I.V drug use!!
Does this mean that I should be really careful about keeping my gums healthy and keeping cuts clean...ect?
ps. sorry about the long ramble, it's late and I'm tired....

 

[Enudely]

the other thing I meant to say (to continue the ramle) was this. I don't know if you know this, but taking those strong antibiotics completely destroys all of the bacteria in your intestines, including all the good ones that you need.
Taking 1200 milligrams or so of acidophilus a day is really helpful to keep those good bacteria alive. Its a good idea for sure... especially if you don't want to have reaccuring problems with yeast infections!

 

[Nancy]

Hi Loz-

My husband takes antibiotics before ANY dental appt., even cleanings. It's better to be safe in this. Endocarditis is something to be avoided ABSOLUTELY!

 

[RWS]

Risk

Risk

Its all about individual risk . The degree to which the your underlying condition creates a risk of endocarditis varies. It?s a little complicated for here but the basically the conditions have to right for the bacteria to stick and take up residence, sort of speak. I had endocarditis three times due to my individual particular underlying condition. I had the perfect set up. Even though now I have a Mech. AV my risk is still rated high but my surgeon tells me many, many times lower than it was! Try this, http://www.aafp.org/afp/980201ap/taubert.html

Randy