Recommendations for Endocarditis Prophylaxis
Recommendations for Endocarditis Prophylaxis
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Taken from: JAMA Dec 1990, VOL 264
Recommendations for Endocarditis Prophylaxis
Endocarditis Prophylaxis Recommended
Prosthetic cardiac valves including bioprosithetic and homograft valves.
Previous bacterial endocarditis, even in the absence of heart disease.
Most congenital cardiac malformations.
Rheumatic and other acquired valvular dysfunction, even after valvular surgery.
Hypertrophic cardiomyopathy
Mitral valve prolapse with valvular regurgitation
Endocarditis Prophylaxis Not Recommended
Isolated secundum atrial septal defect.
Surgical repair without residua beyond 6 mo. of secundum atrial septal defect, ventricular septal defect, or patient ductus arteriosus.
Previous coronary artery bypass graft surgery.
Mitral valve prolapse without valvular regurgitation.
Physiologic, functional or innocent heart murmurs.
Previous Kawasaki disease with valvular dysfunction
Previous rheumatic fever without valvular dysfunction
Cardiac pacemakers and implanted defibrillators.
This table lists selected conditions but is not meant to be all-inclusive.
Individuals who have a mitral valve prolapse associated with thickening and/or redundancy of the valve leaflets may be at increased risk for bacterial endocaditis, particularly men who are 45 years of age or older.
Endocarditis Prophylaxis Recommended for Some Dental or Surgical Procedures
Dental procedures known to induce gingival or mucosal bleeding, including professional cleaning.
Tonsillectomy and/or adenoidectomy
Surgical operations that involve intestinal or respiratory mucosa
Bronchoscopy with a rigid bronchoscope
Scierotherapy for esophageal varices
Esophageal dilatation
Gallbladder surgery
Cystoscopy
Urethral dilatation
Urethral cathetenzation if urinary tract infection is present
Urinary tract surgery if urinary tract infection is present
Prostatic surgery
Incision and drainage of infected tissue
Vaginal hyserectomy
Vaginal delivery in the presence of infection
Prophylaxis Not Recommended for These Procedures
Dental procedures not likely to induce gingival bleeding, such as simple adjustment of orthodonic appliances or fillings above the gum line.
Injection of local intraoral anesthetic (except intraligamentary injections)
Shedding of primary teeth
Tympanostomy tube insertion
Endotracheal intubation
Brochoscopy with a flexible branchoscope, with or without biopsy.
Cardiac catheterization
Endoscopy with or without gastrointestinal biopsy.
Cesarean section
Endoscopy with or without gastrointestinal biopsy
In the absence of infection for urethral catheterization, dilattation and curettage, uncomplicated vaginal delivery, therapeutic abortion, sterilization procedures, or insertion or removal of intrauterine devices.
This table lists selected procedures but is not meant to be all-inclusive.
In addition to prophylactic regimen for genitourinary procedures, antibiotic therapy should be directed against the most likely bacterial pathogen.
In patients who have prosthetic heart valves, a previous history of endocarditis, or surgically constructed system-pulmonary shunts or conduits, physicians may choose to administer prophylactic antibiotics even for low risk procedures that involve the lower respiratory, genitourinary, or gastrointestinal tracts.
Taken from: JAMA Dec 1990, VOL 264
