AHA Updated Premedication Guidelines
Good news for patients requiring antibiotic prophylaxis prior to dental treatment. For decades, guidelines established by the American Heart Association recommended that patients with certain health conditions should take antibiotics prior to dental treatment to prevent infective endocarditis. Recently the American Heart Association and American Dental Association released updated guidelines for antibiotic prophylaxis. This is significant because a large number of patients no longer require antibiotic prophylaxis. Studies have found that in most patients, the risks of antibiotic treatment outweigh the benefits. Adverse effects include severe allergic reactions and the development of drug-resistant bacteria.
Conditions that NO LONGER require antibiotic prophylaxis prior to dental treatment:
- Mitral valve prolapse
- Rheumatic heart disease
- Bicuspid valve disease
- Calcified aortic stenosis
- Congenital heart conditions (ventricular septal defect, atrial septal defect, and hypertrophic cardiomyopathy)
- Physiologic, functional, or innocent heart murmurs
Patients with the following conditions DO STILL REQUIRE antibiotic prophylaxis:
- Artificial heart valves
- History of infective endocarditis
- Cardiac transplant that develops a problem in a heart valve
- Certain specific, serious congenital heart conditions
o Unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
o A completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure
- Prosthetic joint replacement (first 2 years)
Please feel free to review these new guidelines with us. Consult your primary physician regarding our protocol change.
***** To read full text "Endocarditis: Preventing infective endocarditis" update article published in The Journal of the American Dental Association (January 2008), click here. The article explains the 2007 updated guidelines for premedication.