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Prevention
By Mayo Clinic staffPeople with the following heart conditions are at risk of more-serious outcomes from endocarditis:
- Artificial (prosthetic) heart valve
- Previous endocarditis infection
- Certain types of congenital heart defects
- Heart transplant complicated by heart valve problems
People with these conditions may need to take preventive antibiotics before certain medical or dental procedures to prevent endocarditis.
Preventive antibiotics
Certain dental and medical procedures may allow bacteria to enter your bloodstream. Antibiotics taken before these procedures can help destroy or control the harmful bacteria that may lead to endocarditis.
Antibiotics are recommended only before the following procedures:
- Certain dental procedures (those that cut your gum tissue or part of the teeth)
- Procedures involving the respiratory tract, infected skin or tissue that connects muscle to bone
Antibiotics are no longer recommended before all dental procedures or for procedures of the urinary tract or gastrointestinal system.
If you've had to take preventive antibiotics in the past before your dental exams, you may be concerned about these changes. In the past, you were likely told to get antibiotics because of a concern that common dental procedures increased your risk of endocarditis. But as doctors have learned more about endocarditis prevention, they've realized that endocarditis is much more likely to occur from exposure to random germs than from a typical dental exam or surgery.
This doesn't mean it's not important to take good care of your teeth through brushing and flossing. There is some concern that infections in your mouth from poor oral hygiene might increase the risk of germs entering your bloodstream. In addition to brushing and flossing, regular dental exams — at least yearly — are an important part of maintaining good oral health.
- Endocarditis. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=11078. Accessed June 19, 2009.
- Endocarditis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/endo/endo_all.html. Accessed June 19, 2009.
- Sexton DJ. Diagnostic approach to infective endocarditis. http://www.uptodate.com/home/index.html. Accessed May 12, 2009.
- Sexton DJ. Epidemiology, risk factors and microbiology of infective endocarditis. http://www.uptodate.com/home/index.html. Accessed May 12, 2009.
- Spelman D, et al. Complications and outcome of infective endocarditis. http://www.uptodate.com/home/index.html. Accessed May 12, 2009.
- Sexton DJ. Antimicrobial therapy of native valve endocarditis. http://www.uptodate.com/home/index.html. Accessed May 12, 2009.
- Wilson W, et al. Prevention of infective endocarditis. Guidelines for 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.
- Schick EC. Surgery for native valve endocarditis. http://www.uptodate.com/home/index.html. Accessed May 12, 2009.
- Bonow RO, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. Circulation. 2006;114:e84.
