arlete
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New Guidelines for prevention of infective endocarditis (2007) - since we have to be up to date:
PROPHYLAXIS RECOMMENDED:
prostetic cardiac valve; previous IE; congenital heart disease: unrepaired cyanotic CHD, first six months post-op, repaired with residual defects; cardiac transplantation recipients who develop cardiac valvulopathy
PROCEDURES:
all dental involving manipulation of gingival tissue or periapical region of teeth or perforation of the oral mucosa
NO PROPHYLAXIS for gastrointestinal or genitourinary procedures
ANTIBIOTICS: amoxicillin PO or ampicillin IM/IV or cefazolin IM/IV or ceftriaxone IM/IV or clindamycin or azithromycin/clarithromycin (last two in case of penicillin alergy)
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| hgheith
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Thanks Arlete!
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| santatoronto
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"NO PROPHYLAXIS for gastrointestinal or genitourinary procedures "
I dont get it. So they ignore STREP FEACALIS or GRAM NEGATIVE BACTERIA even in high risk patients?
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| neurom
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This is how I understand that. You need to meet both requirements in order to get prophylaxis: underlying heart disease and procedure that can cause bacteremia. GI and GU procedures alone would not lead to endocarditis.
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| arlete
Attending in 2012!!!!!
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Even if you have underlying heart disease, prophylaxis is no longer done for GI and GU procedures.
Link:
http://cardiology.jwatch.org/cgi/content/full/200...
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| arlete
Attending in 2012!!!!!
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It's a matter of cost/benefit. Apparently, the risk of antibiotic use is greater than acquiring IE in these procedures. We are exposed to bacteremia every time we chew, brush our teeth, floss, etc. So the indications were reviewed and simplified.
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| neurom
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Thanks arlete!
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| PGI2alpha
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thanks arlete...thts an important piece of information!!
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| arlete
Attending in 2012!!!!!
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I thought so. But I am a cardiologist and lost an uncle to IE, so I am very biased.
You're welcome.
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| ifiMD
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thanks Arlete!!! very hellpful!! 
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| arlete
Attending in 2012!!!!!
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