Stephen Brunton, MD, Director of Faculty Development, Cabarrus Family Medicine, Charlotte, North Carolina, discusses the most recent update of the AHA clinical guidelines for prevention of Infective Endocarditis. The key summary findings include:
1. Only an extremely small number of cases of infective endocarditis might be prevented by antibiotic prophylaxis for dental procedures even if such prophylactic therapy were 100% effective.
2. Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis.
3. For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.
4. Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of infective endocarditis.
5. Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure.
Wilson W, 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, doi:10.1161/CIRCULATIONAHA.106.183095
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Dr. Brunton has disclosed the following:
Consulting Fees: Pfizer, Novo Nordisk, Amylin, Takeda, Novartis
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