|The full article is available to subscribers||Subscriber Login|
Since 2007, antimicrobial prophylaxis for dental procedures has been recommended only for patients at highest risk of severe consequences from infective endocarditis.1 There is no indication that more limited use of dental prophylaxis since then has led to an increase in the incidence of infective endocarditis.2,3
HIGHEST-RISK PATIENTS — The risk of severe consequences from endocarditis after dental procedures is highest in patients with previous infective endocarditis, prosthetic heart valves, or unrepaired cyanotic congenital heart disease such as tetralogy of Fallot, including those with surgically constructed palliative shunts or conduits. Patients are also considered at highest risk during the first 6 months after repair of congenital heart defects with prosthetic material or a prosthetic device, at any time after a congenital heart repair... more
1. W Wilson et al. Prevention of infective 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 2007; 116:1736.
2. DC Desimone et al. Incidence of infective endocarditis caused by viridans group streptococci before and after publication of the 2007 American Heart Association’s Endocarditis Prevention Guidelines. Circulation 2012; 126:60.