Adult Guidelines
Prevention of Endocarditis

Prevention of Endocarditis

The guidelines for the prevention of infective endocarditis (IE) issued by the American Heart Association underwent a major revision in 2007 and were reaffirmed in 2021. Key changes include the following:

Dental procedures have been found to be associated with a very small number of cases of IE. Prophylaxis, even if 100% effective, would thus prevent only an extremely small number of cases.

The emphasis has shifted from use of antibiotic prophylaxis to good oral health and increased access to dental care.

Maintenance of oral hygeine, rather than antibiotic prophylaxis, is the primary means of reducing the risk of IE via regular brushing, flossing, and dental check-ups to faciliate plaque removal

Prophylactic antibiotics based on a patient’s lifetime risk for acquiring IE are no longer recommended. Instead, prophylaxis focuses on patients with the highest risk for adverse outcomes from endocarditis.