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[Prevention of infectious endocarditis]
1Laboratoire de Bactériologie, Hôpital Cardiovasculaire Louis-Pradel, BP Lyon-Montchat.
Insights
Antibiotic prophylaxis is recommended for high-risk patients undergoing certain dental or surgical procedures to prevent infective endocarditis. Guidelines specify antibiotic choices like amoxicillin, clindamycin, or vancomycin based on procedure type and patient allergies.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Abstract:
An antibiotic prophylaxis of infective endocarditis is recommended in patients at high risk for infective endocarditis (patients with valvular prosthesis, or cyanogen congenital or obstructive cardiac defect) or those with aortic, mitral or tricuspid valvulopathy, a non-cyanogen congenital or obstructive cardiac defect. Dental procedures (except treatment for superficial decay and preparation for the fitting of prostheses to teeth with intact pulp) are to be carried out under local antisepsis and a prophylactic antibiotics, such as 3 g of oral amoxicillin or in case of allergy to penicillin, 600 mg of clindamycin or 1g of pristinamycin, administered one hour prior to the procedure. A similar prophylaxis is recommended for the procedures on the upper respiratory tract. Amoxicillin, or vancomycin or teicoplanin are recommended for procedures under general anaesthesia. For surgery on the intestinal or urogenital tract, regimens combine amoxicillin with gentamicin, or in case of allergy to penicillin, vancomycin or teicoplanin with gentamicin.