endocarditis prevention

endocarditis prevention (prophylaxis)

In the past, children with various predisposing conditions for bacterial endocarditis have been warned to take antibiotics to prevent endocarditis. New guidelines have been released regarding which children require prevention (antibiotic prophylaxis):

children with prosthetic heart valves
those with prior history of infective endocarditis
heart transplant patients with abnormal valves
certain patients with repaired congenital heart defects where the lining of the heart cannot heal properly
children with unrepaired heart defects, or those with palliative shunts
children whose heart defect has been repaired within the past six months - the lining of the heart has not healed sufficiently

Children who meet any of these criteria need prophylaxis before any dental work on the gums, the apex of a tooth, or involving surgery on the oral mucosa (lining of the mouth). Children with innocent heart murmurs (healthy but "noisy" hearts) do not need prophylactic antibiotics.

Amoxicillin is currently used for prophylaxis if the child is not penicillin allergic, in a dose of 2 grams by mouth one hour before the procedure.

Last, remember that since most endocarditis originates from the mouth, good oral hygeine is the most important prevention for endocarditis.

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