Procedures Requiring Antimicrobial Endocarditis Prophylaxis in Patients at High Risk for Endocarditis
Type | Examples |
Oral-dental* | Dental extraction Dental implant placement or reimplantation of avulsed teeth Periodontal procedures, including surgery, scaling, root planing, and probing Prophylactic cleaning of teeth or implants when bleeding is anticipated Root canal instrumentation or surgery beyond the apex |
Respiratory tract | Bronchoscopy if mucosa is to be incised Procedures done during an established infection Tonsillectomy, adenoidectomy, or both |
Gastrointestinal tract | None, unless procedure is done during an established infection |
Genitourinary tract | None, unless procedure is done during an established infection (eg, cystoscopy during known enterococcal urinary tract infection) |
Musculoskeletal | None, unless procedure involves infected tissue |
Skin | None, unless procedure involves infected tissue |
* Examples of oral-dental procedures that do not require prophylaxis are anesthetic injection through uninfected mucosa and placement of orthodontic brackets. | |
Data from Wilson W, Taubert KS, Gewitz M, et al: Prevention of infective endocarditis. Circulation 116 (15):1736–1754, 2007 and Warnes CA, Williams RG, Bashore TM, et al: ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 118(23):e714, 2008. | |