Antibiotic prophylaxis before dental procedures

What it is

Before a dental procedure the question is not which antibiotic to reach for but whether any antibiotic is owed at all. The American Heart Association and the American College of Cardiology have decreased the number of indications for antibiotic prophylaxis prior to dental procedures, and what remains is a short list of cardiac problems. A patient outside that list is given no prophylaxis.

The cardiac conditions that still qualify

Currently antibiotics are indicated for:

• Prosthetic cardiac valves
• Previous infective endocarditis
• Unrepaired cyanotic congenital heart disease, or a repaired congenital defect with a residual shunt
• A cardiac transplant with valve regurgitation due to a structurally abnormal valve

Read the third and fourth with care, because each has a limit written into it. A repaired congenital defect is on the list only where a residual shunt remains, and a cardiac transplant only where there is valve regurgitation due to a structurally abnormal valve.