CHICAGO--Updated guidelines for the prevention of infective endocarditis appear in the June issue of The Journal of the American Dental Association. The guidelines reflect quite a change in direction.
Since 1955, the American Heart Association has recommended that patients with certain heart conditions take antibiotics shortly before dental treatment to prevent IE--a rare, but life-threatening, infection of the heart's inner lining or valves.
IE occurs when bacteria enter the bloodstream and travel to the heart. It was known as "bacterial endocarditis" in the past.
In May, the AHA released updated guidelines it developed with input from the American Dental Association, the Infectious Diseases Society of America and the American Academy of Pediatrics. The guidelines recommend that only patients who are at greatest risk of negative outcomes resulting from IE receive antibiotics.
These patients are those with artificial heart valves or certain congenital heart conditions, heart transplantation recipients who develop cardiac valve problems, recipients of an artificial patch to repair a congenital heart defect within the past six months and patients with a history of IE.
JADA's June cover story, "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," includes these guidelines as they relate to dentistry, as well the writing group's reasons for recommending the changes.
A statement from the ADA's Division of Legal Affairs on the legal perspective on antibiotic prophylaxis accompanies the article. A patient handout page that dentists can use to explain the updated guidelines to their patients also is included.
